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小儿急诊科疑似急性感染性腹泻所致脓毒症患儿的临床表现

Presentations of Children with Suspected Sepsis Caused by Acute Infectious Diarrhea in the Pediatric Emergency Department.

作者信息

Lee Tai-An, Chen Chun-Yu, Chang Yu-Jun, Guo Bei-Cyuan, Lin Wen-Ya, Wu Chao-Hsin, Wu Han-Ping

机构信息

Department of Emergency Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua 50544, Taiwan.

Department of Emergency Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung 43503, Taiwan.

出版信息

Children (Basel). 2024 Jan 29;11(2):171. doi: 10.3390/children11020171.

Abstract

BACKGROUND

Acute infectious diarrhea is a common cause of hospitalization in children. Hence, early identification of acute bacterial gastroenteritis with suspected sepsis in pediatric emergency departments (EDs) is important. This study aimed to describe the clinical spectrum and initial characteristics of children who were presented to a pediatric ED with acute infectious diarrhea and suspected sepsis.

METHODS

Between April 2020 to March 2021, children with clinical diagnoses of acute bacterial colitis and suspected sepsis who were admitted to the pediatric ED were prospectively enrolled. The following data were obtained and compared between different age groups of children: including demographics, presentation, laboratory tests, culture results, treatment modalities, complications, and short-term outcomes.

RESULTS

A total of 105 patients (70 males and 35 females; mean age: 3.75 ± 3.52 years) were enrolled in this study. Of them, 89 (84.8%) patients were <6 years of age, and 80 (76.2%) patients required hospitalization for a duration of 4.7 ± 2.08 days. C-reactive protein (CRP) and procalcitonin (PCT) levels were significantly higher in the admission (both < 0.001) and anti-biotic treatment groups (both < 0.001). was the most common organism cultured from the stool and blood samples (39 of 91 (38.5%) and 2 of 105 (1.9%), respectively).

CONCLUSIONS

The primary causative organism of acute infectious diarrhea identified in this study was . Age and elevated serum CRP or PCT levels could be important factors in the decisions of emergency physicians regarding hospitalization and antibiotic therapies for pediatric acute infectious diarrhea.

摘要

背景

急性感染性腹泻是儿童住院的常见原因。因此,在儿科急诊科(ED)早期识别疑似脓毒症的急性细菌性肠胃炎很重要。本研究旨在描述因急性感染性腹泻和疑似脓毒症就诊于儿科急诊科的儿童的临床谱和初始特征。

方法

在2020年4月至2021年3月期间,前瞻性纳入入住儿科急诊科且临床诊断为急性细菌性结肠炎并疑似脓毒症的儿童。获取以下数据并在不同年龄组儿童之间进行比较:包括人口统计学、临床表现、实验室检查、培养结果、治疗方式、并发症和短期结局。

结果

本研究共纳入105例患者(70例男性和35例女性;平均年龄:3.75±3.52岁)。其中,89例(84.8%)患者年龄<6岁,80例(76.2%)患者需要住院4.7±2.08天。入院时(均<0.001)和抗生素治疗组(均<0.001)的C反应蛋白(CRP)和降钙素原(PCT)水平均显著更高。 是从粪便和血液样本中培养出的最常见病原体(分别在91例中的39例(38.5%)和105例中的2例(1.9%))。

结论

本研究中确定的急性感染性腹泻的主要致病病原体是 。年龄以及血清CRP或PCT水平升高可能是急诊医生决定儿童急性感染性腹泻住院和抗生素治疗的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cde/10887777/eb700ad1ec48/children-11-00171-g001.jpg

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