| 摘要: |
| 目的:探讨儿童颈部蜂窝织炎的病原体分布及用药情况。 方法:回顾性分析我院 2021-2023 年收治的 114 例颈部蜂窝织
炎患儿临床资料,包括流行病学特点、病原体分布和抗菌药物使用情况等。 结果:纳入研究的 114 例患儿中,男女比例 0. 9 ∶ 1。
发病年龄 3 个月 ~14 岁,其中婴幼儿期(0~3 岁)占比最高(48. 25%)。 临床表现为弥漫性肿痛,多伴皮肤发红、触痛、发热等。
病因为上呼吸道感染 61 例、川崎病 12 例、咽后壁感染 10 例、急性淋巴结炎 6 例、化脓性腮腺炎 3 例、口腔溃疡 3 例。 合并感染
类型:4 例血流感染,1 例纵隔蜂窝织炎。 4 例患有基础疾病(急性淋巴细胞白血病)。 114 例患儿中检出致病菌标本 35 例,阳性
检出率为 30. 70%。 检测出的病原菌中葡萄球菌属 25 例、链球菌属 9 例、大肠埃希菌 1 例。 金黄色葡萄球菌对青霉素 G 耐药率
最高,其次为大环内酯类,对苯唑西林耐药率较低,对万古霉素及利奈唑胺耐药率均为 0。 化脓性链球菌对青霉素 G 耐药率较
低,对第三代头孢菌素耐药率均<6. 00%,对大环内酯类耐药率较高,对万古霉素及利奈唑胺耐药率均为 0。 结论:颈部蜂窝织
炎好发于<3 岁儿童,患儿多无基础疾病,以颈部弥漫性肿痛及发热多见,可伴有血流感染或纵隔蜂窝织炎,病原体以金黄色葡
萄球菌及化脓性链球菌常见,除手术治疗(脓肿)外,可经验选择敏感抗菌药物进行有效治疗。 |
| 关键词: 颈部 蜂窝织炎 儿童 病原体 用药分析 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.09.003 |
|
| 基金项目:山西省儿童医院
山西省妇幼保健院 2019 年度院内科研课题项目,编号 201964。 |
|
| PathogenDistributionandMedicationAnalysisofCervicalCellulitisinChildren |
| Zhao Jie |
| (Shanxi
Children’s
Hospital,
Taiyuan 030013,
China) |
| Abstract: |
| Objective:
To
probe
into
the
pathogen
distribution
and
medication
analysis
of
cervical
cellulitis
in
children.
Methods:
Clinical
data
of
114
children
with
cervical
cellulitis
admitted
into
our
hospital
from
2021
to
2023
were
retrospectively
analyzed,
including
epidemiological
characteristics,
pathogen
distribution
and
antibiotics
application.
Results:
Among
the
114
children
enrolled
in
the
study,
the
ratio
of
male
to
female
was
0. 9 ∶ 1.
The
onset
age
of
children
ranged
from
3
months
to
14
years
old,
and
the
proportion
of
children
in
infancy
(from
0
to
3
years)
took
the
lead
(48. 25%).
Clinical
manifestations
were
diffuse
swelling
and
pain,
accompanied
by
skin
redness,
tenderness,
and
fever.
The
causes
were
upper
respiratory
tract
infection
(61
cases),
Kawasaki
disease
(12
cases),
posterior
pharyngeal
wall
infection
(10
cases),
acute
lymphadenitis
(6
cases),
purulent
parotitis
(3
cases)
and
oral
ulcer
(3
cases).
Complicated
infection
types:
4
cases
of
bloodstream
infection,
1
case
of
mediastinal
cellulitis.
Four
cases
had
underlying
disease
(acute
lymphoblastic
leukemia).
Totally
35
samples
of
pathogenic
bacteria
were
detected
in
114
cases,
and
the
positive
detection
rate
was
30. 70%.
The
pathogenic
bacteria
detected
were
Staphylococcus
in
25
cases,
Streptococcus
in
9
cases
and
Escherichia
coli
in
1
case.
Staphylococcus
aureus
had
the
highest
resistance
to
penicillin
G,
followed
by
macrolides,
with
a
lower
resistance
to
oxacillin,
and
0
of
resistance
to
vancomycin
and
linezolid.
Streptococcus
pyogenes
had
a
lower
resistance
to
penicillin
G,
<6. 00%
to
the
third-generation
cephalosporins,
with
a
higher
resistance
to
all
macrolide
antimicrobials,
and
0
to
vancomycin
and
linezolid.
Conclusion:
Cervical
cellulitis
is
common
in
children
under
3
years
old,
mostly
without
underlying
disease,
with
diffuse
swelling
and
pain
in
the
neck
and
fever,
which
may
be
accompanied
by
bloodstream
infection
or
mediastinal
cellulitis.
The
pathogens
are
mainly
S.
aureus
and
S.
pyogenes.
In
addition
to
surgery
( abscess),
sensitive
antibacterial
drugs
can
be
selected
for
effective
treatment. |
| Key words: neck cellulitis children pathogen drug
analysis |
