单核细胞增生李斯特菌感染患者的临床特点分析并文献复习  

Analysis of clinical characteristics and literature review of patients infected with Listeria monocytogenes

作　　者：郑新 郑义雄 蒋夏敏 罗瑶 陈静 刘家琦 阿力木惹 何孜怡 龙怀聪[4] Zhengxin;Zheng Yixiong;Jiang Xiaming;Luo Yao;Chen Jing;Liu Jiaqi;Ali Mure;He Ziyi;LongHuaicong(Department of School of Medicine,University of Electronic Science and Technology of China,Chengdu,China,610000;Department of School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu,China,610075;Department of Clinical Medical,North Sichuan Medical College,Nanchong,China,637100;Department of Geriatric Intensive Care Unit,Sichuan Provincial People's Hospital,University of Electronic Science and Technology,Chengdu,610071,China)

机构地区：[1]电子科技大学医学院,成都610000 [2]成都中医药大学医学与生命科学学院,成都610075 [3]川北医学院临床医学院,南充637100 [4]四川省医学科学院·四川省人民医院(电子科技大学附属医院)老年重症医学科,成都610071

出　　处：《中华急诊医学杂志》2025年第4期528-532,共5页Chinese Journal of Emergency Medicine

摘　　要：目的本研究分析单核细胞增生性李斯特菌感染患者的临床特征、治疗及预后,为该病防治提供依据。方法回顾性分析四川省人民医院近十年明确诊断李斯特菌感染患者的临床资料、辅助检查、治疗及预后。同时检索2014-2024年在知网、万方、PubMed上已发表的文献,总结李斯特菌感染患者的临床特点、治疗方案及预后等情况。结果共收集17例明确诊断李斯特菌感染的患者,年龄(61.29±16.24)岁,血流感染7例,颅内感染3例,血流感染合并颅内感染7例。9例患者合并脓毒症。发病至经验用药的平均时间为72 h,发病至确诊的平均时间为102 h,确诊后使用的抗生素主要为青霉素、美罗培南及万古霉素等。平均住院时间16 d,9例患者预后不佳。检索文献共78篇即共收集到85例患者,年龄(57.96±16.48)岁。主要确诊方法依赖于血/脑脊液培养及NGS。患者主要接受青霉素类、氨基糖苷类、碳青霉烯类及糖肽类抗生素等抗感染方案。然而,预后不良的患者占比仍高达30.6%(26/85)。Logistic回归发现合并脓毒症患者,抗生素使用时间,是患者预后不良的独立因素。结论李斯特菌病是条件致病菌,尽早使用抗生素以及及时对高危人群的识别有助于患者减少预后不良的风险。Objective To analyze the clinical characteristics,treatment strategies,and prognostic outcomes of patients infected with Listeria monocytogenes,thereby providing evidence-based insights for the prevention and control of this disease.Methods A retrospective analysis was performed on the clinical data,diagnostic tests,treatment protocols,and prognostic outcomes of patients defi nitively diagnosed with Listeria monocytogenes infection at Sichuan Provincial People's Hospital over the past decade.Additionally,a comprehensive literature review was conducted,encompassing studies published between 2014 and 2024,sourced from CNKI,Wanfang Data,and PubMed.This review focused on summarizing the clinical features,treatment regimens,and prognostic outcomes of patients with Listeria monocytogenes infection.Results The study cohort comprised 17 patients,with a mean age of(61.29±16.24)years.The confi rmed cases included 7 cases of bloodstream infections,3 cases of central nervous system infections,and 7 cases of combined infections.Sepsis developed in 9 patients.The average time from symptom onset to the initiation of empirical antibiotic therapy was 72 hours,while the mean time to defi nitive diagnosis was 102 hours.Antimicrobial regimens predominantly featured penicillins,meropenem,and vancomycin.The average hospitalization duration was 16 days,with 9 patients experiencing adverse outcomes.A total of 78 relevant literature pieces were retrieved,encompassing data from 85 patients.The average age of these patients was(57.96±16.48)years.Primary diagnostic methods relied on blood/cerebrospinal fl uid cultures and Next-Generation Sequencing(NGS).Treatment regimens primarily involved antibiotics such as penicillins,aminoglycosides,carbapenems,and glycopeptides.Despite these interventions,the proportion of patients with poor prognosis remained significantly high at 30.6%(26/85).Logistic regression analysis identifi ed sepsis and delayed antibiotic administration as independent predictors of poor prognosis.Conclusions Listeriosis,cau

关 键 词：单核细胞增生李斯特菌 脑膜炎 血流感染 预后 青霉素 

分 类 号：R515[医药卫生—内科学]