老年患者草绿色链球菌群感染的临床特征

目的探讨老年患者草绿色链球菌群感染的临床特征和病原菌特点。 方法收集2016年6月至2020年12月济宁医学院附属医院细菌数据库中诊断为草绿色链球菌群感染的老年患者，年龄≥65岁，对其相关临床资料进行回顾性分析及总结。 结果共收集患者75例，其中男性39例(52.00%)，伴基础疾病者55例(73.33%)。30例(40.00%)患者以急性发热起病。分离菌群部位以正常无菌部位例数最多(58/75，77.33%)。具体致病菌分群：缓症链球菌11例(14.67%)、血链球菌14例(18.67%)、咽峡炎链球菌群50例(66.67%)。合并革兰氏阴性杆菌感染6例(8.00%)，诱发中毒性休克综合征2例(2.67%)。药敏结果显示对红霉素、克林霉素、左氧氟沙星的耐药率分别为65.33%(49/75)、68.00%(51/75)、16.00%(12/75)，对头孢曲松(6.67%，5/75)、头孢噻肟(4.00%，3/75)耐药率低。 结论草绿色链球菌群作为常见的感染菌群，在老年人群中易发生机会感染。临床症状以发热常见，致病菌可累及多个系统，严重时可诱发中毒性休克综合征。

Clinical characteristics of infection caused by viridans streptococci in elderly patients

ObjectiveTo explore the clinical characteristics and the pathogen characteristics of viridans streptococci infection in elderly patients. MethodsA total of 75 elderly patients aged 65 years and above who were diagnosed with viridans streptococcal infection in the bacterial database of the Affiliated Hospital of Jining Medical University from June 2016 to December 2020 were sellected, and their related clinical data were summarized and retrospectively analyzed. Results75 elderly patients were collected, including 39 males (52.00%). There were 55 cases (73.33%) with basic diseases. Thirty cases (40.00%) conset by acute fever. The most common type of bacterial culture specimen was sterile body fluid. The classifications of bacterium were as follows: streptococcus mitis in 11 cases (14.67%), streptococcus sanguis in 14 cases (18.67%), streptococcus anginosus in 50 cases (66.67%). Six cases (8.00%) were infected combining with gram-negative bacilli, 2 cases (2.67%) underwent toxic shock syndrome. The drug resistance rates of erythromycin, clindamycin and levofloxacin were 65.33% (49/75), 68.00% (51/75) and 16.00% (12/75) and low resistance rate to ceftriaxone (6.67%, 5/75) and cefotaxime (4.00%, 3/75). ConclusionsStreptococcus virifolia is a common infection group, which is prone to opportunistic infection in the elderly population. Fever is the most common clinical symptom, and pathogenic bacteria may involve multiple systems, and toxic shock syndrome may be induced in severe cases.