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阿根廷门多萨一家儿童医院19年的肺炎球菌侵袭性疾病监测。

Nineteen-years of pneumococcal invasive disease surveillance in a children's hospital in Mendoza, Argentina.

作者信息

Abate Héctor José, Falaschi Andrea, Balbi Laura, García Beatriz

机构信息

Servicio de Infectología, Hospital Pediátrico Dr. Humberto Notti.

Servicio de Microbiología, Hospital Pediátrico Dr. Humberto Notti, Guaymallén, Mendoza, Argentina.

出版信息

Arch Argent Pediatr. 2014 Aug;112(4):352-7. doi: 10.5546/aap.2014.eng.352.

Abstract

Five hundred and thirty-seven children admitted to Hospital Dr. Notti and diagnosed with invasive pneumococcal disease between 1993 and 2011 were studied. Their median age was 19 months (range= 0-192 months); 34.82% were <1 year old and 23.46%, >60 months old. Pneumonia with or without effusion (48.04%) and meningitis (29.05%) were the most predominant conditions, with a case fatality rate of 6.14%. Identified serotypes corresponded to 14, 5 and 1 in56.86% of cases. Sensitivity to penicillin was observed in99.74% of non-meningeal strains, while sensitivity to ceftriaxone was found in 98.08% ofmeningeal strains. Risk factors inpneumonia with effusionwere associated to age >60 months old, RR: 1.47 (1.06-2.04), p= 0.02, to serotype 5, RR: 2.57 (1.71-3.87), p= 0.0001, and to serotype 1, RR: 1.86 (1.17-2.96), p= 0.014; in the case of meningitis, risk factors were mainly associated to age <1 year old, RR: 2.35 (1.87-3.06), p= 0.0000, and to serotype 18C, RR: 2.19 (1.3-3.7), p= 0.024. Conclusion. Streptococcus pneumonia was a major problem in infants younger than one year old, who predominantly developed meningitis which caused half of deaths, and in children older than 60 months old, who had a prevalence of pneumonia with effusion. Most cases were sensitive to penicillin and ceftriaxone.

摘要

对1993年至2011年间入住诺蒂医生医院并被诊断为侵袭性肺炎球菌疾病的537名儿童进行了研究。他们的中位年龄为19个月(范围=0 - 192个月);34.82%的儿童年龄小于1岁,23.46%的儿童年龄大于60个月。伴有或不伴有胸腔积液的肺炎(48.04%)和脑膜炎(29.05%)是最主要的病症,病死率为6.14%。在56.86%的病例中,鉴定出的血清型分别为14型、5型和1型。99.74%的非脑膜菌株对青霉素敏感,而98.08%的脑膜菌株对头孢曲松敏感。伴有胸腔积液的肺炎的危险因素与年龄大于60个月有关,相对危险度(RR):1.47(1.06 - 2.04),p = 0.02,与5型血清型有关,RR:2.57(1.71 - 3.87),p = 0.0001,与1型血清型有关,RR:1.86(1.17 - 2.96),p = 0.014;在脑膜炎病例中,危险因素主要与年龄小于1岁有关,RR:2.35(1.87 - 3.06),p = 0.0000,与18C型血清型有关,RR:2.19(1.3 - 3.7),p = 0.024。结论。肺炎链球菌是1岁以下婴儿的主要问题,这些婴儿主要发生脑膜炎,导致一半的死亡病例,也是60个月以上儿童的主要问题,这些儿童中伴有胸腔积液的肺炎患病率较高。大多数病例对青霉素和头孢曲松敏感。

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