儿童血细菌培养结果的临床分析

目的:分析血细菌培养阳性结果,结合临床体征和抗生素使用情况对儿童败血症做出准确诊断.方法:详细记录58例血培养阳性病例的一般资料、临床体征、实验室检查等情况,对血培养阳性患儿的临床诊断重新判定,对抗生素使用进行评估.结果:58例血培养阳性病例只有28例符合败血症诊断,其中新生儿、婴幼儿和儿童分别有14例、9例和5例.患儿表现有脓疱、脐炎、严重肺炎等,体检指标中体温、血沉和CRP升高及检出细菌较敏感的患儿符合败血症诊断的较多.不同年龄段患儿用药均有不必要治疗和过度治疗.结论:不同年龄段患儿均存在败血症的误诊.患儿临床表现、检出细菌的种类以及对用药的反应有助于败血症的鉴别诊断,避免不必要治疗和过度治疗.

Clinical Analysis of Blood Culture Tests of Children

Objective:Through analysis of the positive blood culture results combined with the clinical features and the reactions to antibiotics,to make exact diagnosis of septicemia in infants.Methods:The diagnosis of those child patients with positive blood culture results were rejudged and their drug therapies were evaluated.Results:Among 58 cases with positive blood culture results,28 cases were in accordance with the septicemia diagnosis,the numbers of cases in different ages were 14(<1 month),9(~3 years) and 5(~10 years),respectively.Most of the cases with the septicemia diagnosis suffered with pustule,omphalitis or severe pneumonia and their temperature,erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) were elevated.Isolated bacteria being sensitive to antibiotics always caused septicemia.Children who received unnecessary treatments and over-treatments could be found in different ages.Conclusions:Misdiagnosis occurred to childrn of different ages.Clinical symptoms,bacterial isolation and responses to antibiotics of patients will help to judge septicemia,avoid unnecessary treatments and over-treatments.