儿童颈部蜂窝织炎的病原体分布及用药分析  

Pathogen Distribution and Medication Analysis of Cervical Cellulitis in Children

作　　者：赵杰[1] Zhao Jie(Shanxi Children’s Hospital,Taiyuan030013,China)

机构地区：[1]山西省儿童医院,太原030013

出　　处：《儿科药学杂志》2024年第9期9-12,共4页Journal of Pediatric Pharmacy

基　　金：山西省儿童医院山西省妇幼保健院2019年度院内科研课题项目,编号201964。

摘　　要：目的:探讨儿童颈部蜂窝织炎的病原体分布及用药情况。方法:回顾性分析我院2021-2023年收治的114例颈部蜂窝织炎患儿临床资料,包括流行病学特点、病原体分布和抗菌药物使用情况等。结果:纳入研究的114例患儿中,男女比例0.9∶1。发病年龄3个月~14岁,其中婴幼儿期(0~3岁)占比最高(48.25%)。临床表现为弥漫性肿痛,多伴皮肤发红、触痛、发热等。病因为上呼吸道感染61例、川崎病12例、咽后壁感染10例、急性淋巴结炎6例、化脓性腮腺炎3例、口腔溃疡3例。合并感染类型:4例血流感染,1例纵隔蜂窝织炎。4例患有基础疾病(急性淋巴细胞白血病)。114例患儿中检出致病菌标本35例,阳性检出率为30.70%。检测出的病原菌中葡萄球菌属25例、链球菌属9例、大肠埃希菌1例。金黄色葡萄球菌对青霉素G耐药率最高,其次为大环内酯类,对苯唑西林耐药率较低,对万古霉素及利奈唑胺耐药率均为0。化脓性链球菌对青霉素G耐药率较低,对第三代头孢菌素耐药率均<6.00%,对大环内酯类耐药率较高,对万古霉素及利奈唑胺耐药率均为0。结论:颈部蜂窝织炎好发于<3岁儿童,患儿多无基础疾病,以颈部弥漫性肿痛及发热多见,可伴有血流感染或纵隔蜂窝织炎,病原体以金黄色葡萄球菌及化脓性链球菌常见,除手术治疗(脓肿)外,可经验选择敏感抗菌药物进行有效治疗。Objective:To probe into the pathogen distribution and medication analysis of cervical cellulitis in children.Methods:Clinical data of 114 children with cervical cellulitis admitted into our hospital from 2021 to 2023 were retrospectively analyzed,including epidemiological characteristics,pathogen distribution and antibiotics application.Results:Among the 114 children enrolled in the study,the ratio of male to female was 0.9∶1.The onset age of children ranged from 3 months to 14 years old,and the proportion of children in infancy(from 0 to 3 years)took the lead(48.25%).Clinical manifestations were diffuse swelling and pain,accompanied by skin redness,tenderness,and fever.The causes were upper respiratory tract infection(61 cases),Kawasaki disease(12 cases),posterior pharyngeal wall infection(10 cases),acute lymphadenitis(6 cases),purulent parotitis(3 cases)and oral ulcer(3 cases).Complicated infection types:4 cases of bloodstream infection,1 case of mediastinal cellulitis.Four cases had underlying disease(acute lymphoblastic leukemia).Totally 35 samples of pathogenic bacteria were detected in 114 cases,and the positive detection rate was 30.70%.The pathogenic bacteria detected were Staphylococcus in 25 cases,Streptococcus in 9 cases and Escherichia coli in 1 case.Staphylococcus aureus had the highest resistance to penicillin G,followed by macrolides,with a lower resistance to oxacillin,and 0 of resistance to vancomycin and linezolid.Streptococcus pyogenes had a lower resistance to penicillin G,<6.00%to the third-generation cephalosporins,with a higher resistance to all macrolide antimicrobials,and 0 to vancomycin and linezolid.Conclusion:Cervical cellulitis is common in children under 3 years old,mostly without underlying disease,with diffuse swelling and pain in the neck and fever,which may be accompanied by bloodstream infection or mediastinal cellulitis.The pathogens are mainly S.aureus and S.pyogenes.In addition to surgery(abscess),sensitive antibacterial drugs can be selected for effective treatment.

关 键 词：颈部 蜂窝织炎 儿童 病原体 用药分析 

分 类 号：R978.1[医药卫生—药品]