成人侵袭性沙门菌属感染23例临床分析

发布时间：2018-05-19 14:45

  本文选题：沙门菌属 + 侵袭性沙门菌属感染　； 参考：《首都医科大学学报》2017年05期

【摘要】：目的分析总结侵袭性沙门菌属感染病例的临床特点及沙门菌属的抗生素药物敏感性,为临床诊治提供依据。方法回顾性分析首都医科大学附属北京朝阳医院2010年3月至2016年10月住院的23例成人侵袭性沙门菌感染病例的临床表现、实验室检查、治疗预后及抗生素敏感性。结果 23例病人中位年龄62(19,83)岁,男女比例为17∶6,合并基础疾病/情况的有18例(78.26%)。12例形成肠外局部感染病人的中位年龄为67.5岁,其中91.67%合并基础病,4例为感染性动脉瘤。临床表现:高热(T≥39℃)者20例(86.96%),寒战者21例(91.3%),腹泻7例(30.43%),全血白细胞中位数9.22(2.53,26.33)×109/L,白细胞10×109/L者13例(56.5%),嗜酸性粒细胞比例≤0.005者18例(78.26%)。住院病人中19例临床治愈或好转出院,2例转院治疗,死亡2例。环丙沙星和氨苄西林敏感性较其他6种抗生素低(分别为37.5%和34.78%),且差异具有统计学意义,环丙沙星中介的占到56.25%(9/16)。结论侵袭性沙门菌感染好发于中老年及合并基础疾病者,临床表现为多种疾病形式,多有寒战高热,少有腹泻,超半数全血白细胞不升高且大部分病人嗜酸性粒细胞减少。动脉粥样硬化病人合并沙门菌血流感染时要警惕感染性动脉瘤的形成。选择抗生素时避免氨苄西林及环丙沙星,可以考虑三代头孢及左氧氟沙星。
[Abstract]:Objective to analyze the clinical characteristics of invasive Salmonella infection cases and the antibiotic sensitivity of Salmonella so as to provide evidence for clinical diagnosis and treatment. Methods the clinical manifestation, laboratory examination, prognosis and antibiotic sensitivity of 23 adult patients with invasive Salmonella infection in Beijing Chaoyang Hospital affiliated to Capital Medical University from March 2010 to October 2016 were retrospectively analyzed. Results the median age of 23 patients was 62 / 19 / 83), the ratio of male to female was 17: 6. The median age of 18 patients with basic diseases / conditions was 67.5 years old. The median age of 12 patients with local infection was 67.5 years old. Among them, 91.67% of the patients with underlying diseases were infectious aneurysms. The clinical manifestations were as follows: 20 cases with high fever T 鈮，

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