既往健康儿童社区获得性铜绿假单胞菌脓毒症

目的 总结既往健康儿童社区获得性铜绿假单胞菌脓毒症的临床特点,分析导致死亡的危险因素.方法 回顾性分析本院收治的34例社区获得性铜绿假单胞菌脓毒症患儿的临床资料,根据预后分为存活组、死亡或放弃治疗组,比较二组患儿年龄、性别、发病季节、入院前病程、临床表现和治疗情况.应用SPSS 11.0软件进行统计学分析.结果 34例患儿中男25例,女9例;≤1岁21例(62%);28例(82%)在5-10月份发病.存活13例(38%),其中7例有后遗症;死亡15例(44%);6例(18%)因存活概率极低家长放弃治疗.临床表现以发热、腹泻、腹胀、呼吸急促或呼吸困难最常见.20例(59%)发生皮肤坏疽性深脓疱.34例入院前均曾接受抗生素治疗,其中所用抗生素名称明确的22例,抗菌谱均未覆盖铜绿假单胞菌.入院时合并休克26例(76%)、呼吸衰竭25例(74%)、多脏器功能障碍19例(56%).死亡或放弃治疗组休克(χ2=4.33,P=0.037)、呼吸衰竭(χ2=10.75,P=0 001)、多脏器功能障碍(χ2=9.19,P=0.002)发生率明显高于存活组.结论 既往健康儿童社区获得性铜绿假单胞菌脓毒症并非罕见.可疑患儿初始抗感染治疗应使用覆盖铜绿假单胞菌的抗生素.合并休克、呼吸衰竭、多脏器功能障碍和初始抗生素使用不合理是导致死亡的危险因素.

Community-Acquired Pseudomonas Aeruginosa Sepsis in Previously Healthy Children

Objective To investigate the clinical characteristics and risk factors for mortality of community-acquired pseudomonas aeruginosa sepsis in previously healthy children.Methods The materials of 34 hospitalized patients with community-acquired pseudomonas aeruginosa sepsis in previously healthy children were analyzed retrospectively.All patients were divided into survival group and death or treatments discontinued group according to the prognosis.The differences of age,gender,occurrence season,the course of d...