| 摘要: |
| 目的:分析儿童耐甲氧西林金黄色葡萄球菌(MRSA)急性及亚急性骨关节感染的临床特征及危险因素,为临床早期识别 及合理用药提供参考。 方法:回顾性分析河北医科大学第三医院 2018-2022 年收治的病原菌阳性的急性及亚急性骨关节感染 患儿的人口统计学、临床和病原学资料。 根据病原菌分为 MRSA 组和非 MRSA 组,采用 logistic 回归分析 MRSA 感染的危险因 素。 结果:本研究共纳入 104 例患儿,男 63 例、女 41 例,年龄 9. 0(6. 3,12. 0)岁,≤5 岁 24 例,5 ~ 16 岁 80 例。 首发症状主要为 发热 82 例(78. 8%)、局部肿痛 75 例(72. 1%)、肿痛伴活动受限 47 例(45. 2%)。 MRSA 组 40 例,非 MRSA 组 64 例,其中 MRSA 检出率为 43. 5%。 单因素和 logistic 回归分析显示,年龄 5~16 岁和居住农村是 MRSA 感染的独立危险因素(P<0. 05)。 此外, MRSA 组手术次数多于非 MRSA 组。 2018-2022 年,MRSA 对克林霉素耐药率呈上升趋势。 结论:本地区急性及亚急性儿童骨 关节感染以发热、局部肿痛、活动受限为主要表现,MRSA 检出率为 43. 5%,MRSA 感染可能面临更多手术干预;年龄 5 ~ 16 岁和 居住农村地区是 MRSA 感染的危险因素。 |
| 关键词: 骨关节感染 儿童 耐甲氧西林金黄色葡萄球菌 危险因素 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.09.003 |
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| 基金项目:河北省卫生健康委医学科学研究课题,编号 20230727。 |
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| Clinical Characteristics and Risk Factors for Methicillin-Resistant Staphylococcus Aureus Acute and Subacute Osteoarticular Infections in Children |
| Zhang Yongzan, Guo Meng, Pei Xinjian, An Jingzhi |
| (Hebei Medical University Third Hospital, Shijiazhuang 050051, China) |
| Abstract: |
| Objective: To analyze the clinical characteristics and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acute and subacute osteoarticular infections in children, and to provide references for early clinical identification and rational drug use. Methods: Retrospectively analysis was performed on the demographic, clinical, and microbiological data of children with culture- positive acute and subacute osteoarticular infections in Hebei Medical University Third Hospital from 2018 to 2022. Based on bacteriological results, cases were categorized into the MRSA group and non-MRSA group. Logistic regression was used to identify independent risk factors for MRSA infection. Results: A total of 104 patients were enrolled, 63 cases were males, and 41 cases were females. The age of the presentation was 9. 0 (6. 3, 12. 0) years, including 24 patients aged from 0 to 5 years and 80 patients aged from 5 to 16 years. The initial symptoms were fever in 82 patients (78. 8%), local swelling and pain in 75 patients (72. 1%), and swelling and pain with limited mobility in 47 patients (45. 2%). There were 40 cases in the MRSA group and 64 cases in the non-MRSA group, with an MRSA detection rate of 43. 5%. Univariate and multivariate logistic regression analysis showed that, patients aged from 5 to 16 years and rural residence were independently associated with MRSA infection ( P < 0. 05). Meanwhile, the MRSA group had more surgical procedures than the non-MRSA group, and the resistance rate of MRSA to clindamycin showed a fluctuant upward trend from 2018 to 2022. Conclusion: In this region, acute and subacute osteoarticular infections in children predominantly present with fever, local swelling and pain, and limited mobility, with an MRSA detection rate of 43. 5%. MRSA infection may require more surgical interventions, age from 5 to 16 years and rural residence are identified as independent risk factors. |
| Key words: osteoarticular infections children methicillin-resistant Staphylococcus aureus risk factors |
