Guo Danchun, Zhuang Shuting, Lu Qinghua, Chen Yunsheng, Meng Qing, Sun Lifang, Zheng Yuejie, Wang Wenjian, Yu Dingle
Shenzhen Children's Hospital, Shantou University Medical College, Shenzhen, Guangdong, China.
Front Med (Lausanne). 2024 Aug 9;11:1438624. doi: 10.3389/fmed.2024.1438624. eCollection 2024.
is one of the common pathogens of suppurative infections. Invasive group A (iGAS) infections often develop from skin or soft tissue infections, and streptococcal toxic shock syndrome is considered the main cause of death in Chinese children with iGAS infectious disease. However, soft tissue infections caused by iGAS infections, especially the formation of abscesses, are relatively rare. A retrospective study was conducted, and pediatric in-patients who were diagnosed with an iGAS infection identified by cultures from normally sterile sites and treated in a tertiary hospital during 2016-2018 were included. A total of 14 patients were identified, which included 10 boys and four girls. The patients had an age range from 3 months to 10 years and were diagnosed with soft tissue infections and a formation of abscesses caused by iGAS infections. The most common sites of infections were the lower limbs. In five patients, the abscess was accompanied by fever, and the local soft tissue showed redness, swelling, tenderness, and an elevated skin temperature. Laboratory findings included an increased white blood cell (WBC) count in 12 patients, an increased C reactive protein (CRP) level in seven patients, and an increased erythrocyte sedimentation rate (ESR) in 10 patients. No patients had an elevated procalcitonin level. For all 14 patients, we performed puncture and drainage of abscesses, and cultured GAS from the drainage fluid. All children also received antibiotic treatment. During 2 months of follow-up, the patients' condition remained stable and no evidence of kidney or heart damage was observed. For pediatric patients with abscesses, early diagnosis, prompt treatment with incision and drainage, and immediate culture of the drainage fluid are important. Upon confirmation of an iGAS infection, β-lactam antibiotics should be given to provide effective treatment, and in some patients with poor therapeutic outcomes, the use of vancomycin as an alternative can achieve the desired results.
是化脓性感染的常见病原体之一。侵袭性A组(iGAS)感染通常由皮肤或软组织感染发展而来,链球菌中毒性休克综合征被认为是中国iGAS传染病患儿死亡的主要原因。然而,iGAS感染引起的软组织感染,尤其是脓肿的形成相对少见。进行了一项回顾性研究,纳入了2016 - 2018年期间在一家三级医院住院、经正常无菌部位培养确诊为iGAS感染并接受治疗的儿科患者。共确定了1名患者,其中包括10名男孩和4名女孩。患者年龄在3个月至10岁之间,被诊断为iGAS感染引起的软组织感染和脓肿形成。最常见的感染部位是下肢。5名患者的脓肿伴有发热,局部软组织表现为发红、肿胀、压痛和皮肤温度升高。实验室检查结果包括12名患者白细胞(WBC)计数升高,7名患者C反应蛋白(CRP)水平升高,10名患者红细胞沉降率(ESR)升高。没有患者降钙素原水平升高。对所有14名患者进行了脓肿穿刺引流,并从引流液中培养出GAS。所有儿童也都接受了抗生素治疗。在2个月的随访期间,患者病情保持稳定,未观察到肾脏或心脏损伤的迹象。对于患有脓肿的儿科患者,早期诊断、及时进行切开引流治疗以及对引流液立即进行培养很重要。确诊为iGAS感染后,应给予β - 内酰胺类抗生素进行有效治疗,对于一些治疗效果不佳的患者,使用万古霉素作为替代药物可取得理想效果。