Brook I
Department of Pediatrics, Georgetown University School of Medicine, Washington, D.C., USA.
Pediatr Dermatol. 1996 Jul-Aug;13(4):281-4. doi: 10.1111/j.1525-1470.1996.tb01239.x.
Specimens obtained from eight children with necrotizing fasciitis (NF) were cultured for aerobic and anaerobic bacteria. A total of 21 isolates were recovered, 13 anaerobic and 8 aerobic or facultatives. The facultative organism Streptococcus pyogenes was present alone in two (25%) instances, and mixed aerobic and anaerobic bacteria were isolated in six (75%). The predominant isolates were Peptostreptococcus spp. (6 isolates, including 3 Peptostreptococcus magnus). S. pyogenes (4), Bacteroides fragilis group (3), Clostridium perfringens (2), Escherichia coli (2), and Prevotella spp. (2). Organisms similar to the ones isolated from the NF aspirates were recovered in the blood of all patients except one. These included S. pyogenes (3 isolates). B. fragilis group (2), E. coli (1), and P. magnus (1) and Clostridium perfringens (1). All patients underwent surgical fasciotomy, and four required skin grafting. Antimicrobials were administered to all children. Despite extensive resection and intense supportive therapy, three patients died from sepsis accompanied by shock acidosis and disseminated intravascular coagulation. These findings illustrate the polymicrobial aerobic-anaerobic flora of NF in children.
从八名患有坏死性筋膜炎（NF）的儿童身上获取的标本进行了需氧菌和厌氧菌培养。共分离出21株菌株，其中13株为厌氧菌，8株为需氧菌或兼性菌。兼性菌化脓性链球菌单独出现的情况有两例（25%），需氧菌和厌氧菌混合分离的情况有六例（75%）。主要分离菌株为消化链球菌属（6株，包括3株大消化链球菌）、化脓性链球菌（4株）、脆弱拟杆菌群（3株）、产气荚膜梭菌（2株）、大肠埃希菌（2株）和普雷沃菌属（2株）。除一名患者外，所有患者血液中均分离出与从NF抽吸物中分离出的相似的微生物。这些微生物包括化脓性链球菌（3株）、脆弱拟杆菌群（2株）、大肠埃希菌（1株）、大消化链球菌（1株）和产气荚膜梭菌（1株）。所有患者均接受了外科筋膜切开术，其中四名患者需要植皮。所有儿童均接受了抗菌药物治疗。尽管进行了广泛切除和积极的支持治疗，但仍有三名患者死于败血症，伴有休克酸中毒和弥散性血管内凝血。这些发现说明了儿童NF的多微生物需氧-厌氧菌丛情况。
