儿童流感嗜血杆菌感染特点及疾病进展的影响因素  

Characteristics and disease progression of Haemophilus influenzae infection in children

作　　者：李香玉 郑慧娟 樊艳婷 Li Xiangyu;Zheng Huijuan;Fan Yanting(Laboratory Department,Tongchuan People's Hospital,Tongchuan 727000,China;Transfusion Department,Xi'an International Medical Center Hospital,Northwest University,Xi'an 710010,China)

机构地区：[1]铜川市人民医院检验科,铜川727000 [2]西北大学附属西安国际医学中心医院输血科,西安710010

出　　处：《国际医药卫生导报》2025年第2期265-269,共5页International Medicine and Health Guidance News

基　　金：国家自然科学基金(82202550)。

摘　　要：目的探讨儿童侵袭性流感嗜血杆菌感染的临床特点、耐药情况及影响疾病进展的相关因素。方法采用回顾性分析,选取2021年1月至2023年12月在铜川市人民医院诊治的500例侵袭性流感嗜血杆菌感染患儿为研究对象,男329例,女171例,年龄1个月~6岁。收集病例的性别、年龄、检查结果、药敏结果等临床信息,总结疾病临床特点及耐药情况。根据病情状态分为重症组(227例)与非重症组(273例),分析研究影响疾病进展的相关因素。统计学方法采用t、χ^(2)检验、logistic回归分析及受试者操作特征曲线(ROC)。结果500例侵袭性流感嗜血杆菌感染患儿中,新生儿21例,婴儿242例,幼儿139例,学龄前期儿童98例,患病季节集中在4月~6月、12月~1月。症状表现:发热367例、咳嗽412例、痰鸣音125例、喘鸣音147例、发热合并咳嗽289例。合并其他病原体感染的有211例,其中呼吸道合胞病毒35例、肺炎支原体41例、卡他莫拉菌71例、金黄色葡萄球菌64例。药敏结果显示,非敏感率:复方新诺明71.36%(309/433),红霉素62.38%(262/420),氨苄西林57.67%(282/489),阿奇霉素41.13%(153/372),环丙沙星1.65%(7/423),头孢呋辛0.21%(1/479);三代头孢基本敏感,氨苄西林/舒巴坦大部分敏感。logistic回归分析结果显示,年龄、高发季节、合并感染情况可能为影响侵袭性流感嗜血杆菌感染患儿疾病进展的独立危险因素(OR=13.067、1.263、6.863,均P<0.05)。ROC显示,年龄、高发季节、合并感染情况对侵袭性流感嗜血杆菌感染患儿疾病进展具有较强灵敏度,曲线下面积分别为0.701、0.606、0.685。结论儿童侵袭性流感嗜血杆菌感染集中发生于<3岁的婴幼儿,春冬两季为高发季节,临床症状主要以发热与咳嗽为主,同时易感染其他致病菌株;三代头孢作为首选治疗药物;年龄、高发季节、合并感染情况为影响侵袭性流感嗜血杆菌感染患儿疾病进展的独立危险因素�Objective To explore the clinical characteristics,drug resistance and related factors affecting disease progression of invasive Haemophilus influenzae infection in children.Methods This was a retrospective survey.Five hundred children with invasive Haemophilus influ‐enzae infection treated at Tongchuan People's Hospital from January 2021 to December 2023 were selected as the study objects,including 329 boys and 171 girls who were 1 month to 6 years old.DO1:10.3760/20240301-02017 Their clinical information,such as gender,age,examination results,and drug sensitivity results were collected.The clinical characteristics and drug resistance were summarized.According to the condition status,they were divided into a severe group(227 cases)and a non-severe group(273 cases).The related factors affecting the disease progress were analyzed.t and χ^(2) tests,logistic regression analysis,and receiver operating characteristics curve(ROC)were used for the statistical analysis.Results Among the 500 children,there were 21 newborns,242 infants,139 young children,and 98 preschool children.The infection seasons were concentrated from April to June and from December to January.Three hundred and sixty-seven cases had fever,412 cough,125 sputum sounds,147 wheezing sounds,and 289 fever and cough.Two hundred and eleven cases had infections by other pathogens,including 35 cases infected by respiratory syncytial virus,41 by Mycoplasma pneumoniae,71 by Moraxella catarrhalis,and 64 by Staphylococcus aureus.The drug sensitivity test results showed that the non-sensitive rates to cotrimoxazole,erythromycin,ampicillin,azithromycin,cip‐rofloxacin,and cefuroxime were 71.36%(309/433),62.38%(262/420),57.67%(282/489),41.13%(153/372),1.65%(7/423),and 0.21%(1/479),respectively;it was basically sensitive to third-generation cephalosporins,and most were sensitive to ampicillin/sulbactam.The results of logistic regression analysis showed that age,high incidence seasons,and co-infection might be the independent risk factors for disease progression in

关 键 词：儿童 侵袭性流感嗜血杆菌感染 临床特点 疾病进展 耐药 

分 类 号：R44[医药卫生—诊断学]