Feng Ping, Tan Ming-zhen, Chen Zhi-hai, Xue Xin-sheng, Tang Hong, Liu Zi-gui, Ma Jun-qing, Zhong Ming, Yuan Shun-qing
Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2007 Sep;38(5):874-8.
To analysis the clinical features and efficacy of treatment for patients with type 2 Streptococcus suis (S. suis 2) infection, and to inform better diagnosis and treatment of S. suis 2.
Clinical data of 68 patients with S. suis 2 infection were retrieved retrospectively. The diagnoses were confirmed by clinical symtom or/and isolation of S. suis 2 from the infected sites in Shichuan province in the summer of 2005. The patients ranged from general type (simple sepsis) to septic shock type; meningitis type and mixed type.
The outbreak of S. suis 2 infection occurred in June to August in 2005. The common source of infection came from pigs. The people in great risks were farmers who exposed to sick or dead pigs with S. suis 2 infection. Most infection occurred on the people who slaughtered infected pigs, followed by those who dressed infected meats. The prominent symptoms included fever with sharp chills, dizziness, headache, malaise and myalgia. Some patients had abdominal pain and diarrhea. Septic shock and coma often occurred in severe cases. According to the clinical manifestations, patients were categorized into four different clinical types: general type, septic shock type, meningitis type, and mixed type. S. suis 2 isolated from the patients were susceptible to most antimicrobial agents, except for tetracycline. All of the patients were treated with beta-lactam antibiotics (penicillins or cephalosporins). Some were given combined antimicrobial agents. Seventy seven percent (52/68) of patients survived. All of the general patients recovered completely. Fifty eight percent (15/26) of patients with septic shock died. The artificial ventilation and persistent blood filtering treatment played an important role for treating patients with septic shock. Although most patients with meningitis (97.5%) survived, a decrease in hearing or even hearing loss occurred to some of the survivors.
Purulent meningitis and septic shock are the major clinical manifestations for S. suis 2 infection in human. The treatment for patients with meningitis is more effective than that for patients with septic shock.
分析2型猪链球菌（S. suis 2）感染患者的临床特征及治疗效果，为S. suis 2的诊治提供依据。
回顾性分析68例S. suis 2感染患者的临床资料。诊断依据2005年夏季四川省患者的临床症状及/或从感染部位分离出S. suis 2确定。患者病情从普通型（单纯败血症）到感染性休克型、脑膜炎型及混合型。
2005年6至8月发生S. suis 2感染疫情。常见感染源为猪。高危人群为接触感染S. suis 2的病猪或死猪的农民。多数感染发生在屠宰感染猪的人群中，其次是处理感染猪肉的人群。突出症状包括高热寒战、头晕、头痛、乏力及肌痛。部分患者有腹痛及腹泻。重症患者常发生感染性休克及昏迷。根据临床表现，患者分为四种不同临床类型：普通型、感染性休克型、脑膜炎型及混合型。从患者分离出的S. suis 2对多数抗菌药物敏感，四环素除外。所有患者均接受β-内酰胺类抗生素（青霉素或头孢菌素）治疗。部分患者给予联合抗菌药物治疗。77%（52/68）的患者存活。所有普通型患者均完全康复。感染性休克型患者中58%（15/26）死亡。人工通气及持续血液滤过治疗对感染性休克患者的治疗起重要作用。尽管多数脑膜炎型患者（97.5%）存活，但部分幸存者出现听力下降甚至失聪。
化脓性脑膜炎及感染性休克是人类S. suis 2感染的主要临床表现。脑膜炎型患者的治疗效果优于感染性休克型患者。
