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中间型链球菌所致胸膜肺部感染的临床和微生物学特征

Clinical and microbiologic characteristics of pleuro-pulmonary infection due to Streptococcus intermedius.

作者信息

Cobo F, Sampedro A, Rodríguez-Granger J, Aliaga-Martínez L, Navarro-Marí J M

机构信息

Fernando Cobo, Department of Microbiology, Hospital Virgen de las Nieves Avda Fuerzas Armadas, 2 18014 Granada, Spain.

出版信息

Rev Esp Quimioter. 2018 Apr;31(2):146-151. Epub 2018 Mar 22.

Abstract

The clinical and microbiological characteristics of pleuro-pulmonary infection (PPI) caused by Streptococcus intermedius is described, including 6 cases in the literature and 9 cases handled at the present centre. Out of the 15 patients, 12 were male; mean age at diagnosis was 62.06 ± 15 years. Twelve had risk factors for S. intermedius infection such as alcoholism in 5 (35.7%) patients, periodontal disease in 3 (24.6%) cases, chronic obstructive pulmonary disease in 3 (24.6%), and diabetes mellitus in 2 (14.2%). Cough was present in 12 (80%) patients and chest pain and dyspnea in 9 (60%). The mean diagnosis interval was 34 days. The diagnosis was obtained from pleural fluid aspirate in 13 (86.6%) cases and from biopsy/tissue samples in 2. The most frequently antimicrobials used for treatment were ceftriaxone + levofloxacin. Ten patients cured with a combination of medical and surgical treatment and 2 patients died as a consequence of infection. The incidence of PPI caused by S. intermedius is increasing in our health area; drainage along with antibiotic therapy is recommended for treatment.

摘要

本文描述了由中间型链球菌引起的胸膜肺部感染(PPI)的临床和微生物学特征,包括文献报道的6例以及本中心收治的9例。15例患者中,12例为男性;诊断时的平均年龄为62.06±15岁。12例患者有中间型链球菌感染的危险因素,如5例(35.7%)患者存在酗酒,3例(24.6%)患有牙周病,3例(24.6%)患有慢性阻塞性肺疾病,2例(14.2%)患有糖尿病。12例(80%)患者有咳嗽症状,9例(60%)有胸痛和呼吸困难症状。平均诊断间隔为34天。13例(86.6%)患者的诊断来自胸腔积液抽吸物,2例来自活检/组织样本。治疗最常用的抗菌药物是头孢曲松+左氧氟沙星。10例患者通过药物和手术联合治疗治愈,2例患者因感染死亡。在我们的医疗区域,由中间型链球菌引起的PPI发病率正在上升;建议采用引流加抗生素治疗。

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