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目的分析侵袭性肺炎链球菌病(IPD)临床特征及血清学分布资料,为IPD诊断与治疗提供参考依据。方法回顾性分析2009年1月-2013年12月收治的43例IPD患儿临床资料及分离出51株肺炎链球菌(SPN)血清型分布,采用SPSS17.0软件进行统计分析。结果临床特征显示,IPD患儿以两岁以下居首位占58.14%;67.44%患儿冬春季发病,83.72%患儿为社区获得性感染;疾病谱主要是败血症占48.84%、化脓性脑膜炎占18.61%、化脓性胸膜炎占16.28%;5例占11.63%有基础疾病,以先天性心脏病最多见;临床治愈28例、好转11例、3例未愈自动出院,死亡1例;5例并发症分别是脓毒性休克2例,急性呼吸窘迫综合征、硬膜下积液及癫痫各1例;51株SPN常见血清型是19F、19A、14和9V,分别占27.45%、19.61%、17.65%和9.81%,有1株无法确定血清型。结论 IPD好发于2岁以下患儿,疾病谱以败血症最多见,血清型主要是19F、19A、14和9V,推荐接种13价肺炎链球菌结合疫苗。
Objective To analyze the clinical features and serological distribution of invasive pneumococcal disease (IPD), and to provide a reference for the diagnosis and treatment of IPD. Methods The clinical data of 43 children with IPD admitted from January 2009 to December 2013 were retrospectively analyzed. Serotypes of 51 strains of Streptococcus pneumoniae (SPN) were isolated and analyzed by SPSS17.0 software. Results Clinical features showed that children with IPD accounted for 58.14% of the patients under the age of two, 67.44% of children were infected in winter and spring, and 83.72% of children were community-acquired infections. The disease spectrum was mainly sepsis 48.84%, purulent meningitis Accounting for 18.61%, purulent pleurisy accounted for 16.28%; 5 cases accounted for 11.63% of the underlying diseases, the most common congenital heart disease; clinically cured in 28 cases, improved in 11 cases, 3 cases were not discharged automatically, 1 died; 5 cases The complications were 2 cases of septic shock, 1 case of acute respiratory distress syndrome, 1 case of subdural effusion and epilepsy respectively. The common serotypes of 51 strains of SPN were 19F, 19A, 14 and 9V, accounting for 27.45% and 19.61% 17.65% and 9.81% respectively. One strain could not confirm the serotype. Conclusions IPD occurs in children under 2 years old. The spectrum of sepsis is most common. The serotypes are mainly 19F, 19A, 14 and 9V. It is recommended to inoculate the 13-valent pneumococcal conjugate vaccine.