中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
24期
105-107
,共3页
胡鸿伟%程国平%戴昕%张振%向赟
鬍鴻偉%程國平%戴昕%張振%嚮赟
호홍위%정국평%대흔%장진%향빈
重症肺炎%抗生素相关性腹泻%儿童%病原菌%肠镜
重癥肺炎%抗生素相關性腹瀉%兒童%病原菌%腸鏡
중증폐염%항생소상관성복사%인동%병원균%장경
Severe pneumonia%Antibiotic-associated diarrhea%Children%Pathogenic bacteria%Colonoscopy
目的：探讨重症肺炎患儿继发抗生素相关性腹泻（Antibiotic-associated diarrhea，AAD）的肠道病原菌及肠镜情况。方法：回顾性分析本院2012年3月-2014年3月本院内科重症监护室283例重症肺炎继发AAD患儿的临床资料，检测肠道病原菌，电镜观察肠道病理变化。结果：283例患儿的粪便检出艰难梭菌（Clostridium difficile，CD）毒素阳性标本48例，283例患儿的粪便培养后检出优势生长的白色假丝酵母菌127例、大肠埃希氏菌114例、金黄色葡萄球菌43例、产气荚膜梭菌35例、产酸克雷伯菌26例、阴沟肠杆菌19例、肺炎克雷伯菌16例、铜绿假单胞菌8例。电镜检查CD相关性AAD（CDAD）26例有黄白色伪膜斑，其他病原菌相关性AAD 67例显示有炎性变化。结论：重症肺炎继发AAD患儿的病原菌种类较复杂，以优势生长的白色假丝酵母菌、大肠埃希氏菌检出率最高。肠镜检测CDAD与其他病原菌相关性AAD显示出不同的炎症变化。
目的：探討重癥肺炎患兒繼髮抗生素相關性腹瀉（Antibiotic-associated diarrhea，AAD）的腸道病原菌及腸鏡情況。方法：迴顧性分析本院2012年3月-2014年3月本院內科重癥鑑護室283例重癥肺炎繼髮AAD患兒的臨床資料，檢測腸道病原菌，電鏡觀察腸道病理變化。結果：283例患兒的糞便檢齣艱難梭菌（Clostridium difficile，CD）毒素暘性標本48例，283例患兒的糞便培養後檢齣優勢生長的白色假絲酵母菌127例、大腸埃希氏菌114例、金黃色葡萄毬菌43例、產氣莢膜梭菌35例、產痠剋雷伯菌26例、陰溝腸桿菌19例、肺炎剋雷伯菌16例、銅綠假單胞菌8例。電鏡檢查CD相關性AAD（CDAD）26例有黃白色偽膜斑，其他病原菌相關性AAD 67例顯示有炎性變化。結論：重癥肺炎繼髮AAD患兒的病原菌種類較複雜，以優勢生長的白色假絲酵母菌、大腸埃希氏菌檢齣率最高。腸鏡檢測CDAD與其他病原菌相關性AAD顯示齣不同的炎癥變化。
목적：탐토중증폐염환인계발항생소상관성복사（Antibiotic-associated diarrhea，AAD）적장도병원균급장경정황。방법：회고성분석본원2012년3월-2014년3월본원내과중증감호실283례중증폐염계발AAD환인적림상자료，검측장도병원균，전경관찰장도병리변화。결과：283례환인적분편검출간난사균（Clostridium difficile，CD）독소양성표본48례，283례환인적분편배양후검출우세생장적백색가사효모균127례、대장애희씨균114례、금황색포도구균43례、산기협막사균35례、산산극뢰백균26례、음구장간균19례、폐염극뢰백균16례、동록가단포균8례。전경검사CD상관성AAD（CDAD）26례유황백색위막반，기타병원균상관성AAD 67례현시유염성변화。결론：중증폐염계발AAD환인적병원균충류교복잡，이우세생장적백색가사효모균、대장애희씨균검출솔최고。장경검측CDAD여기타병원균상관성AAD현시출불동적염증변화。
Objective:To investigate the intestinal pathogen and colonoscopy of antibiotic-associated diarrhea in children with severe pneumonia.Method:283 children with severe pneumonia in our hospital were analyzed retrospectively the etiological data of antibiotic associated diarrhea from March 2012 to March 2014. Result:The results dictated there were 48 samples toxin-positive of clostridium difficile,and after culturing there were 127 cases of Candida albicans,114 cases of Escherichia coli,43 cases of Staphyloccocus aureus,35 cases of clostridium perfringens,26 cases of Klebsiella oxytoca,19 cases of enterobacter cloacae,16 cases of Klebsiella pneumoniae and 8 cases of pseudomonas aeruginosa in the fecal specimens of 283 severe pneumonia children with antibiotic associated diarrhea. Colonoscopy detection showed there were 26 cases of pseudomembranous spots in all CD infection children,67 cases of inflammatory in other bacterial infections children. Conclusion:Severe pneumonia children with antibiotic associated diarrhea have complicated pathogens,the best pathogens are candida albicans and Escherichia coli. Colonoscopy detection shows different inflammatory changes in these pathogens associated AAD.
