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[新生儿百日咳的临床特征及病原菌的耐药性]

[Clinical characteristics of whooping cough in neonates and antimicrobial resistance of the pathogenic bacteria].

作者信息

Luo Jie, Wang Hui-Xin, Yuan Lin, Gu Song, Jiang Min, Ding Yi-Jun, Guo Dan, Yao Kai-Hu, Wang Ya-Juan

机构信息

Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2014 Oct;16(10):975-8.

Abstract

OBJECTIVE

To study the clinical characteristics of whooping cough in neonates and the antimicrobial resistance of the bacterial isolates.

METHODS

Clinical information of 7 neonates with whooping cough confirmed by bacterial culture was collected. The antimirobial resistance of the isolates was tested using E-test and disk diffusion methods.

RESULTS

The children′s mothers or other family members had cough for more than 10 days in 6 neonates, in which four neonates contacted with 3 or more family members with cough. All the neonates had rhinobyon and slight cough at the beginning of the disease. Five cases presented typical spasmodic cough after 4-7 days of the onset. Five cases displayed cyanosis, four cases occurred apnea, three cases suffered breath holding, and only two cases had fever. Nares flaring and three depression signs were found in the physical examination. No bacteriostatic ring around the erythromycin disks were found for five bacterial isolates. The minimal inhibitory concentration (MIC) for erythromycin, azithromycin, clarithromycin and clindamycin were all >256 mg/L against the five isolates.

CONCLUSIONS

Whooping cough should be considered for neonates with respiratory symptoms and a history of close contact with respiratory infection patients. Macrolide-resistant Bordetella pertussis is common in children with whooping cough.

摘要

目的

研究新生儿百日咳的临床特征及细菌分离株的抗菌耐药性。

方法

收集7例经细菌培养确诊为百日咳的新生儿的临床资料。采用E-test法和纸片扩散法检测分离株的抗菌耐药性。

结果

6例新生儿的母亲或其他家庭成员咳嗽超过10天,其中4例新生儿与3名或更多咳嗽的家庭成员有接触。所有新生儿在疾病初期均有鼻塞和轻微咳嗽。5例在发病4-7天后出现典型的痉挛性咳嗽。5例出现发绀,4例发生呼吸暂停,3例出现屏气,仅2例发热。体格检查发现鼻翼扇动和三凹征。5株细菌分离株在红霉素纸片周围未发现抑菌圈。5株分离株对红霉素、阿奇霉素、克拉霉素和克林霉素的最低抑菌浓度(MIC)均>256mg/L。

结论

对于有呼吸道症状且有与呼吸道感染患者密切接触史的新生儿,应考虑百日咳。大环内酯类耐药百日咳博德特菌在百日咳患儿中很常见。

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