32例儿童链球菌中毒性休克综合征药物治疗疗效分析

Drug treatment efficacy in 32 children with streptococcal toxic shock syndrome

摘要:

目的 分析儿童链球菌中毒性休克综合征（streptococcal toxic shock syndrome, STSS）不同药物治疗方案的疗效。方法 回顾性收集2009年1月—2023年4月在湖南省儿童医院和郴州市第一人民医院经细菌培养证实为化脓性链球菌感染且符合STSS诊断标准患儿的临床资料，分析药物治疗疗效。根据药物治疗方案分为4组：标准组（含青霉素的方案）、A组（碳青霉烯类+糖肽类/利奈唑胺）、B组（碳青霉烯类、广谱抗生素、糖肽类/利奈唑胺单用或联用，但除外A组的方案）、C组（大环内酯类/未使用抗菌药物）。结果 共纳入32例STSS患儿。药敏试验显示所有菌株对氨苄西林等β-内酰胺类抗菌药物和左氧氟沙星、万古霉素敏感，对克林霉素、红霉素及四环素耐药。标准组、A组、B组、C组4组间有效率的比较差异有统计学意义（P<0.05），其中标准组有效率最高（100%），A组、B组、C组有效率分别为40%、40%、0%。结论 使用含青霉素的抗菌方案可提高儿童STSS治疗疗效。

Abstract:

Objective To study the efficacy of different drug treatment regimens in children with streptococcal toxic shock syndrome (STSS).Methods Clinical data of children diagnosed with STSS confirmed by bacterial culture and treated in Hunan Children's Hospital and Chenzhou First People's Hospital from January 2009 to April 2023 were retrospectively collected. The efficacy of different drug treatment regimens was analyzed. The children were divided into four groups based on the treatment regimens: standard group (regimens containing penicillin), Group A (carbapenem + glycopeptides/linezolid), Group B (carbapenems, broad-spectrum antibiotics, glycopeptides/linezolid used alone or in combination, excluding the regimens in Group A), and Group C (macrolides/not receiving antimicrobial drugs).Results A total of 32 cases of STSS were included. Antimicrobial susceptibility testing showed that all strains were sensitive to beta-lactam antibiotics such as ampicillin and vancomycin, while resistant to clindamycin, erythromycin, and tetracycline. There was a statistically significant difference in the efficacy rate among the four groups (P<0.05). The standard group exhibited the highest efficacy rate (100%), while the efficacy rates for Group A, Group B, and Group C were 40%, 40%, and 0%, respectively.Conclusions The use of antimicrobial regimens containing penicillin can improve the therapeutic efficacy of STSS in children.