李斯特菌病患者的临床特征。
Clinical characteristics of patients with listeriosis.
机构信息
Department of Hospital Infection Management, First Hospital of Changsha, Changsha 410005.
Infection Control Center, Xiangya Hospital, Central South University, Changsha 410008.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Mar 28;46(3):257-262. doi: 10.11817/j.issn.1672-7347.2021.200399.
OBJECTIVES
To investigate the clinical characteristics of patients with listeriosis and to provide a basis for diagnosis, treatment, prevention and control of hospital infection.
METHODS
A total of 10 inpatients, who suffered from the listeriosis in Xiangya Hospital, Central South University from January 2013 to June 2019, were retrospectively collected for this study. The characteristics of the patients' age, gander, basic information, case type, clinical manifestations, first consultation department, days of diagnosis, infection indicator, specimen type, results of drug sensitivity, treatment plan, hospital infection or not, outcome, follow-up data were analyzed.
RESULTS
Two cases were pregnant women and other were non-pregnant adults among 10 patients with listeriosis. Among them, there were 3 cases with hospital acquired infection. The age of patient onset was 27-71 years old, and the time from onset to diagnosis was 5-36 days. Five cases had fever, and other 5 cases had not fever. There were headache, fatigue, local pain, and other specialized symptoms in the 10 patients.The white blood cell count,the neutrophil ratio, the inflammatory index C-reactive protein, the procalcitonin were all increased, and the erythrocyte sedimentation was accelerated in the 10 patients.All the patients were sensitive to ampicillin, penicillin G, meropenem, and compound sinomine.
CONCLUSIONS
Listeriosis often affects the patients with low immunity, which often leads to misdiagnosis or missed diagnosis in clinic.So early prevention, early diagnosis, and early treatment can reduce mortality; it is important for departments of nosocomial infection management to manage patients' diet for avoiding outbreaks of listeriosis in hospital.
目的
探讨李斯特菌病患者的临床特点，为临床诊断、治疗、预防和医院感染控制提供依据。
方法
回顾性收集 2013 年 1 月至 2019 年 6 月中南大学湘雅医院收治的 10 例李斯特菌病住院患者的临床资料，分析患者的年龄、性别、基础信息、病例类型、临床表现、首诊科室、确诊时间、感染指标、标本类型、药敏结果、治疗方案、是否发生医院感染、转归、随访等情况。
结果
10 例李斯特菌病患者中，孕妇 2 例，非孕妇成人 8 例；医院获得性感染 3 例。患者发病年龄为 2771 岁，发病至确诊时间为 536 天。5 例发热，5 例无发热。10 例患者均有头痛、乏力、局部疼痛等非特异性症状。白细胞计数、中性粒细胞比例、炎症指标 C 反应蛋白、降钙素原均升高，红细胞沉降率加快。10 例患者均对氨苄西林、青霉素 G、美罗培南、复方磺胺甲噁唑敏感。
结论
李斯特菌病好发于免疫力低下人群，易导致临床误诊或漏诊。早期预防、诊断和治疗可降低病死率；医院感染管理部门对患者饮食进行管理，可避免医院李斯特菌病的暴发流行。
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