儿童坏死性软组织感染的临床特征及危险因素
The clinical characteristics and risk factors for necrotizing soft tissue infection in children.
作者信息
Liu Jing, Chen Jigang, Wang Yanni, Qi Hongyan, Yu Jing
机构信息
Department of Burn and Plastic Surgery Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing China.
出版信息
Pediatr Investig. 2023 Dec 4;8(1):21-26. doi: 10.1002/ped4.12408. eCollection 2024 Mar.
IMPORTANCE
Necrotizing soft tissue infection (NSTI) is a serious infectious disease. However, the early clinical manifestations and indicators of NSTI in children are still unclear.
OBJECTIVE
The purpose of this study was to analyze the clinical characteristics and risk factors of NSTI in pediatric patients.
METHODS
A total of 127 children with skin and soft tissue infection (SSTI) were treated at our hospital and divided into two groups: the NSTI group and the non-NSTI group, based on their discharge diagnosis from January 2011 to December 2022. Then, we collected and analyzed the clinical characteristics and risk factors of all patients, including sex and age, disease inducement, admission temperature, local skin manifestations, infection site, the presence of sepsis, bacterial culture, and laboratory indicators.
RESULTS
In our study, there was a statistical difference in the age distribution and disease inducement between NSTI and non-NSTI groups. The occurrence of local skin manifestations (blisters/bullae and ecchymosis) and the presence of sepsis significantly increased in the NSTI group compared to the non-NSTI group. Additionally, only the platelet count on laboratory tests was statistically different between the NSTI and non-NSTI groups. Finally, the logistic regression analysis suggested that local skin manifestations such as blisters/bullae, and ecchymosis, as well as the presence of sepsis, were identified as risk factors for NSTI.
INTERPRETATION
Children with SSTI and skin manifestations such as blisters/bullae, ecchymosis, and the presence of sepsis are at a higher risk of developing NSTI. These symptoms serve as useful indicators for early detection of NSTI.
重要性
坏死性软组织感染（NSTI）是一种严重的传染病。然而，儿童NSTI的早期临床表现和指标仍不明确。
目的
本研究旨在分析儿科患者NSTI的临床特征和危险因素。
方法
2011年1月至2022年12月期间，我院共收治127例皮肤和软组织感染（SSTI）患儿，并根据出院诊断将其分为两组：NSTI组和非NSTI组。然后，我们收集并分析了所有患者的临床特征和危险因素，包括性别、年龄、疾病诱因、入院体温、局部皮肤表现、感染部位、脓毒症的存在、细菌培养和实验室指标。
结果
在我们的研究中，NSTI组和非NSTI组在年龄分布和疾病诱因方面存在统计学差异。与非NSTI组相比，NSTI组局部皮肤表现（水疱/大疱和瘀斑）的发生率和脓毒症的存在显著增加。此外，实验室检查中只有血小板计数在NSTI组和非NSTI组之间存在统计学差异。最后，逻辑回归分析表明，水疱/大疱和瘀斑等局部皮肤表现以及脓毒症的存在被确定为NSTI的危险因素。
解读
患有SSTI且有皮肤表现如水疱/大疱、瘀斑以及存在脓毒症的儿童发生NSTI的风险更高。这些症状是早期检测NSTI的有用指标。
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