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目的探讨婴儿巨细胞病毒(CMV)肺炎合并其他条件致病菌感染的临床特点、治疗方法。方法通过ELISA法检测血清CMV特异性抗体IgM,荧光定量PCR检测尿、痰液CMV-DNA,结合临床症状胸片确诊42例婴儿CMV肺炎,其中25例合并其他条件致病菌感染。结果婴儿CMV肺炎的临床表现复杂多样,缺乏特异性。表现为反复咳喘、伴或不伴发热、两肺细湿啰音和哮鸣音。其中25例标本的细菌培养阳性,致病菌多见革兰阴性菌,部分产超广谱β-内酰胺酶(ESBLs)。给更昔洛韦及敏感抗生素治疗后治愈。结论对婴儿CMV肺炎治疗效果欠佳时,要重视痰液病原菌检查,行细菌培养选用敏感抗生素治疗。
Objective To investigate the clinical characteristics and treatment of infantile cytomegalovirus (CMV) pneumonia complicated with other pathogenic bacteria infections. Methods Serum CMV-specific IgM was detected by ELISA. CMV-DNA in urine and sputum was detected by real-time PCR. Twenty-four infants with CMV pneumonia were diagnosed by clinical chest radiography. Twenty-five of them were infected with other pathogenic bacteria. Results The clinical manifestations of infant CMV pneumonia are complex and diverse and lack specificity. The performance of repeated cough, with or without fever, two lungs wet rales and wheeze. Among them, 25 cases were positive for bacterial culture, and gram-negative bacteria were common in pathogens. Some of them were ESBLs-producing strains. Give ganciclovir and sensitive antibiotics cured after treatment. Conclusions When the curative effect of CMV pneumonia in infants is not good, we should pay attention to the sputum pathogenic bacteria examination and select the sensitive antibiotics for bacterial culture.