小儿社区获得性铜绿假单胞菌脓毒症临床分析

目的 探讨儿童社区获得性铜绿假单胞菌脓毒症的临床特点.方法 回顾性分析复旦大学儿科医院重症监护中心2003年5月至2007年5月收治的12例铜绿假单胞菌脓毒症的发病情况.结果 12例儿童发病前均系健康儿童;突发起病,以毒血症状(12例)、高热(12例)、感染性休克(6例)、重症肺炎(12例)、特异性皮疹(6例)为主要特征,疾病进展迅速,很快发生1～6个脏器功能的衰竭;血清或渗出物培养阳性率高.药敏显示,社区获得性感染中铜绿假单胞菌对绝大部分抗革兰阴性杆菌抗生素敏感,对复方磺胺甲噁唑均耐药;12例中6例死亡.结论 铜绿假单胞菌脓毒症在儿童社区获得性感染中占有一定比例,发病有一定的特征,病情进展迅速,易导致多脏器损害.早期发现,早期干预是治疗的关键.

The Clinical analysis of sepsis caused by community acquired pseudomonas aeruginosa infection in infants.

Objective To analyze the clinical features of sepsis caused by community acquired pseudomonas aeruginosa infection. Methods We analyzed retrospectively the pictures of 12 cases with sep-sis infected by community acquired pseudomonas aeruginosa in Children's Hospital of Fudan University from May 2003 to May 2007. Results Twelve cases were healthy before these episodes. Their symptoms devel-oped quickly within 1 to 5 days and presented with endotoxiemia (12 cases) ,high fever (12 cases) ,septic shock (6 cases), severe pneumonia (12 cases) and atopic dermatitis (6 cases). Their features progressed rapidly and 1 to 6 organs dysfunction occurred. Bacteria culture of serum and exudates had a high positive rate. Drug sensitivity test showed the pseudomonas aeruginosa from community were sensitive to the majority of anti-gram positive antibodies except SMZco. Six cases died at last. Conclusion Pseudomonas aeruginosa sepsis has a low incidence in children, but their clinical features deteriorate rapidly, and are subject to multiple organ dysfunction. Early diagnose and early intervention are the keys to treatment.