Brook I
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.
J Med Microbiol. 1995 Feb;42(2):78-82. doi: 10.1099/00222615-42-2-78.
A survey of the isolation of Clostridium spp. from 1543 specimens sent to anaerobic microbiology laboratories revealed 113 isolates from 107 specimens (7.0% of all specimens) from 96 children. The isolates comprised 43 (38%) unidentified Clostridium spp., 37 (33%) C. perfringens, 13 (12%) C. ramosum, five (4%) C. innocuum, six (5%) C. botulinum, three (3%) C. difficile, two (2%) C. butyricum, and one isolate each of C. bifermentans, C. clostridiiforme, C. limosum and C. paraputrificum. Most clostridial isolates were from abscesses (38), peritonitis (26), bacteraemia (10), and chronic otitis media (7). Predisposing or underlying conditions were present in 31 (32%) cases. These were immunodeficiency (12), malignancy (9), diabetes (7), trauma (7), presence of a foreign body (6) and previous surgery (6). The clostridia were the only bacterial isolates in 14 (15%) cases; 82 (85%) cases had mixed infection. The species most commonly isolated with clostridia were anaerobic cocci (57); Bacteroides spp. (B. fragilis group) (50), Escherichia coli (22), pigmented Prevotella or Porphyromonas spp. (18) and Fusobacterium spp. (10). Most Bacteroides and Escherichia coli isolates with clostridia were from abdominal infections and skin and soft tissue infections adjacent to the rectal area; most pigmented Prevotella and Porphyromonas isolates were from oropharyngeal, pulmonary, and head and neck sites. Antimicrobial therapy was given to all patients, in conjunction with surgical drainage in 34 (35%). Only two patients died. These data illustrate the importance of Clostridium spp. in paediatric infections.
一项针对送往厌氧微生物实验室的1543份标本进行梭菌属分离的调查显示，从96名儿童的107份标本（占所有标本的7.0%）中分离出113株菌株。这些分离菌株包括43株（38%）未鉴定的梭菌属、37株（33%）产气荚膜梭菌、13株（12%）多枝梭菌、5株（4%）无害梭菌、6株（5%）肉毒梭菌、3株（3%）艰难梭菌、2株（2%）丁酸梭菌，以及双发酵梭菌、梭状芽孢杆菌、黏液梭菌和副腐败梭菌各1株。大多数梭菌分离株来自脓肿（38例）、腹膜炎（26例）、菌血症（10例）和慢性中耳炎（7例）。31例（32%）病例存在易感或基础疾病。这些疾病包括免疫缺陷（12例）、恶性肿瘤（9例）、糖尿病（7例）、创伤（7例）、异物存在（6例）和既往手术史（6例）。在14例（15%）病例中，梭菌是唯一分离出的细菌；82例（85%）病例存在混合感染。最常与梭菌共同分离出的菌种是厌氧球菌（57例）；拟杆菌属（脆弱拟杆菌群）（50例）、大肠埃希菌（22例）、产色素普雷沃菌或卟啉单胞菌属（18例）和梭杆菌属（10例）。大多数与梭菌共同分离出的拟杆菌和大肠埃希菌来自腹部感染以及直肠区域附近的皮肤和软组织感染；大多数产色素普雷沃菌和卟啉单胞菌分离株来自口咽、肺部以及头颈部部位。所有患者均接受了抗菌治疗，34例（35%）患者同时接受了手术引流。仅2例患者死亡。这些数据说明了梭菌属在儿科感染中的重要性。
