儿童侵袭性A组链球菌感染的临床和流行病学特征

Clinical and epidemiologic features of invasive group A streptococcal infections in children.

作者信息

Mulla Zuber D

机构信息

Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center School of Medicine at El Paso, El Paso, Texas 79905, USA.

出版信息

Pediatr Int. 2007 Jun;49(3):355-8. doi: 10.1111/j.1442-200X.2007.02378.x.

DOI:10.1111/j.1442-200X.2007.02378.x

PMID:17532835

Abstract

BACKGROUND

Invasive group A streptococcal infection (IGASI) is a disease of public health importance. The clinical epidemiology of IGASI in children has not been studied extensively in Florida, USA. The objective of this study was to describe the clinical and epidemiologic features of children hospitalized for IGASI in Florida, USA, during a 4-year period.

METHODS

Data from a previous retrospective cohort study of IGASI were analyzed. The study subjects were children and adults who had been hospitalized throughout Florida for IGASI between 1996 and 2000 and reported to the Florida Department of Health. A total of 25 patients who were 0 to 17 years of age were identified and included in the current pediatric case series.

RESULTS

The median age at the time of admission was 4 years (range, 0.05-17 years). A total of 14 cases (56%) were boys. In total, 18 of the pediatric patients had group A streptococcal bacteremia and three children were diagnosed with group A streptococcal necrotizing fasciitis. Various antibiotic regimens were used. A total of 33% (7/21) of the patients received clindamycin during their hospital stay. Data on mortality were available for 23 pediatric IGASI cases and 205 adult IGASI cases. The mortality rate was 4.4% in children as compared to 19.5% in adults (Fisher's two-sided P = 0.087).

CONCLUSIONS

The low case-fatality in children was consistent with other pediatric series of IGASI.

摘要

背景

侵袭性A组链球菌感染（IGASI）是一种具有公共卫生重要性的疾病。在美国佛罗里达州，儿童IGASI的临床流行病学尚未得到广泛研究。本研究的目的是描述美国佛罗里达州4年间因IGASI住院的儿童的临床和流行病学特征。

方法

对之前一项关于IGASI的回顾性队列研究的数据进行分析。研究对象为1996年至2000年间在佛罗里达州因IGASI住院并向佛罗里达州卫生部报告的儿童和成人。共确定了25名年龄在0至17岁之间的患者，并将其纳入当前的儿科病例系列。

结果

入院时的中位年龄为4岁（范围为0.05至17岁）。共有14例（56%）为男孩。总共有18名儿科患者发生A组链球菌菌血症，3名儿童被诊断为A组链球菌坏死性筋膜炎。使用了各种抗生素治疗方案。共有33%（7/21）的患者在住院期间接受了克林霉素治疗。可获得23例儿科IGASI病例和205例成人IGASI病例的死亡率数据。儿童死亡率为4.4%，而成人死亡率为19.5%（Fisher双侧P = 0.087）。