| 秦海荣,冯 晅,王沁芳,王晓林,冀 璐.儿童流感病毒合并肺炎链球菌感染的临床特征及相关因素分析[J].,2024,(15):2950-2954 |
| 儿童流感病毒合并肺炎链球菌感染的临床特征及相关因素分析 |
| Clinical Characteristics and Related Factors Analysis of Influenza Virus Combined with Streptococcus Pneumoniae Infection in Children |
| 投稿时间：2024-01-26 修订日期：2024-02-22 |
| DOI：10.13241/j.cnki.pmb.2024.15.028 |
| 中文关键词: 儿童 流感病毒 肺炎链球菌 临床特征 影响因素 |
| 英文关键词: Children Influenza virus Streptococcus pneumoniae Clinical features Influencing factors |
| 基金项目:山西省重点研发计划项目（202003D31163） |
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| 中文摘要: |
| 摘要 目的：探讨儿童流感病毒合并肺炎链球菌感染的临床特征及相关因素。方法：选取我院2020年12月到2023年11月收治的70例流感病毒合并肺炎链球菌感染患儿进行回顾性分析，将其分为观察组，另选取同期来我院治疗的70例单纯流感病毒感染患儿作为对照组，对比两组患儿临床特征，分析70例流感病毒合并肺炎链球菌感染患儿药敏试验情况，对比观察组与对照组患儿预后水平与并发症发生率，最后采取logistics回归模型，以肺炎链球菌感染为因变量（合并肺炎链球菌感染=1，未合并肺炎链球菌感染=0）分析儿童流感病毒合并肺炎链球菌感染的危险因素。结果：观察组与对照组患儿性别、发热峰值、高热、抽搐症状、接种流感疫苗情况对比无明显差异（P＞0.05），年龄、流感病毒感染病程、发热病程、湿啰音、意识障碍、气促、喘息症状、接种肺炎球菌疫苗、中性粒细胞升高、白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT）水平对比差异显著（P＜0.05）；观察组共分离出70株肺炎链球菌，其对头孢噻肟、青霉素、头孢曲松、万古霉素、利奈唑胺、厄他培南、泰利霉素、左氧氟沙星敏感度较高，对复方新诺明、四环素、美罗培南、红霉素敏感度较低；观察组患儿咳嗽改善时间、发热改善时间、住院时间明显长于对照组，并发症发生总数明显高于对照组（P＜0.05）；中性粒细胞升高、CRP升高、PCT升高为儿童流感病毒合并肺炎链球菌感染的危险因素，接种肺炎球菌疫苗为保护因素（P＜0.05）。结论：儿童流感病毒合并肺炎链球菌感染与单纯流感病毒感染相比病程长，以湿啰音、意识障碍、气促、喘息等为特异性症状，并发症发生率较高，预后较差，伴随中性粒细胞升高、WBC、CRP、PCT水平升高情况，且对头孢噻肟、青霉素、头孢曲松、万古霉素、利奈唑胺、厄他培南、泰利霉素、左氧氟沙星敏感度。进一步分析表明，中性粒细胞升高、CRP升高、PCT升高为儿童流感病毒合并肺炎链球菌感染的危险因素，接种肺炎球菌疫苗为保护因素。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical characteristics and related factors of influenza virus combined with streptococcus pneumoniae infection in children. Methods: A retrospective analysis was conducted on 70 children with influenza virus combined with streptococcus pneumoniae infection admitted to our hospital from December 2020 to November 2023. They were divided into an observation group and another 70 children with simple influenza virus infection who were treated in our hospital during the same period were selected as the control group. The clinical characteristics of the two groups of children were compared, and the drug sensitivity test of 70 children with influenza virus combined with streptococcus pneumoniae infection was analyzed. The prognosis and incidence of complications were compared between the observation group and the control group. Finally, a logistic regression model was used to analyze the risk factors of influenza virus combined with streptococcus pneumoniae infection in children as the dependent variable (combined with streptococcus pneumoniae infection=1, not combined with streptococcus pneumoniae infection=0). Results: There was no significant difference in gender, peak fever, high fever, convulsive symptoms, and influenza vaccine administration between the observation group and the control group (P>0.05). However, there were significant differences in age, influenza virus infection duration, fever duration, wet rales, consciousness disorders, shortness of breath, wheezing symptoms, pneumococcal vaccine administration, elevated neutrophils, white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) levels between the observation group and the control group (P<0.05); A total of 70 Streptococcus pneumoniae strains isolated from the observation group showed higher sensitivity to cefotaxime, penicillin, ceftriaxone, vancomycin, linezolid, ertapenem, thalimycin, and levofloxacin, and lower sensitivity to cotrimoxazole, tetracycline, meropenem, and erythromycin; Elevated neutrophils, elevated CRP, and elevated PCT are risk factors for influenza virus associated streptococcus pneumoniae infection in children, while pneumococcal vaccination is a protective factor (P<0.05). Conclusion: Compared with simple influenza virus infection, influenza virus combined with streptococcus pneumoniae infection in children has a longer course of disease, with specific symptoms such as wet rales, consciousness disorders, shortness of breath, and wheezing. The incidence of complications is higher, and the prognosis is poor. It is accompanied by elevated neutrophils, WBC, CRP, and PCT levels, and sensitivity to cefotaxime, penicillin, ceftriaxone, vancomycin, linezolid, ertapenem, telimacin, and levofloxacin. Further analysis shows that elevated neutrophils, elevated CRP, and elevated PCT are risk factors for influenza virus combined with streptococcus pneumoniae infection in children, and pneumococcal vaccination is a protective factor. |
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