摘要
目的探讨单核细胞增生李斯特菌感染患者临床表现,实验室检查,抗生素使用及预后情况,为临床早期诊断、治疗该病提供依据。方法回顾性收集深圳市人民医院2015年1月—2020年12月出现感染临床症状,并经血培养或脑脊液培养确诊的李斯特菌感染10例患者的临床资料,分析患者的临床特征、实验室检查、治疗方案及预后。结果10例患者中包括7例成年患者及3例新生儿。成年患者主要症状为高热,伴随白细胞计数、中性粒细胞比值、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)升高;新生儿则主要表现为气促、发绀,体温不高,缺乏典型症状;早期明确单核细胞李斯特菌感染后使用β-内酰胺类药物为主的治疗方案,可明显降低患者死亡。本研究10例患者仅有1例死亡,余9例好转出院。结论李斯特菌感染主要见于免疫力低下人群且常伴神经系统感染。早期明确病原学诊断并使用β-内酰胺类药物能够明显改善患者预后。
Objective To investigate the clinical manifestation,laboratory examination,antibiotic use,and prognosis of patients with Listeria monocytogenes,so as to provide evidence for early diagnosis and treatment of the disease.Methods The clinical data of 10 patients with Listeria monocytogenes infection confirmed by blood culture or cerebrospinal fluid culture in Shenzhen People’s Hospital from January 2015 to December 2020 were collected retrospectively.The clinical characteristics,laboratory examination,treatment,and prognosis were analyzed.Results Among 10 patients,there were seven adults and three newborns.The main symptoms of adult patients were high fever,with the increase of white blood cell count,neutrophil ratio,hypersensitive C-reactive protein(hs-CRP),and procalcitonin(PCT),while newborns were mainly characterized by shortness of breath,cyanosis,low body temperature,and lack of typical symptoms.Early identification of the treatment of Listeria monocytogenes infection withβ-lactamase antibiotics can significantly reduce the death rate of the patients.Of the 10 patients in this study,only one died and the other nine cases were improved and discharged from the hospital.Conclusion Listeria monocytogenes infection is mainly found in people with low immunity and is often accompanied by nervous system infection.Early etiological diagnosis and use ofβ-lactamase antibiotics drugs can significantly improve the prognosis of patients.
作者
蒋钟吉
许智坤
吴劲松
霍梅
徐勇
刘雪燕
Jiang Zhong-ji;Xu Zhi-kun;Wu Jing-song;Huo Mei;Xu Yong;Liu Xue-yan(The Second Clinical Medical College of Jinan University,Shenzhen People’s Hospital,Shenzhen 518020;Shenzhen Second People’s Hospital,Shenzhen 518035)
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2022年第11期1202-1206,共5页
Chinese Journal of Antibiotics
基金
深圳市重症感染防治重点实验室(No.DSYS20200811142804014)
深圳市医学重点学科建设经费资助(No.SZXK053)。
关键词
单核细胞增生李斯特菌
感染
抗生素
临床特征
感染控制
Listeria monocytogenes
Infection
Antibiotics
Clinical characteristics
Infection control
作者简介
蒋钟吉,男,生于1995年,在读硕士研究生,主要研究方向为脓毒症、微生物,E-mail:993044186@qq.com;通讯作者:刘雪燕,E-mail:1736574753@qq.com。
