基于病例报告的儿童解没食子酸链球菌感染系统评价
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R181.3+2 R378.1+2

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河南省医学科技攻关计划联合共建项目(LHGJ20200604)


Streptococcus gallolyticus infection in children: a systematic review based on case reports
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    摘要:

    目的 系统评价儿童解没食子酸链球菌(SG)感染的临床特点。方法 系统检索PubMed、Embase、Web of Science、中国知网、万方和维普数据库,检索时限均为建库至2024年3月15日。纳入儿童SG感染的病例报告或病例系列报告文献,排除综述、仅有摘要不能获取全文的文献和中、英文以外的文献。2位研究人员独立采用病例报告质量评价工具表(JBI)对纳入的文献进行质量评价,提取文献信息,总结SG感染的临床特点。结果 纳入35篇文献,65例患儿,其中,男性40例,女性22例,3例未报告性别;发病年龄20 h~3.5岁;菌血症53例,细菌性脑膜炎38例,感染性心内膜炎4例,尿路感染2例,肝脓肿1例;SG菌株对青霉素敏感率较高(96.1%);菌血症和脑膜炎多采用青霉素G、氨苄西林或头孢噻肟单药治疗,少数联用2种抗菌药物,4例心内膜炎均联用2种抗菌药物,1例肝脓肿联用3种抗菌药物;60例存活,4例死亡,1例未报告临床结局;7例脑膜炎患儿出现神经系统并发症,1例心内膜炎患儿并发肾小球肾炎。结论 儿童SG感染人群以低龄儿童为主,尤其是新生儿,导致的疾病以菌血症和脑膜炎最为常见,大部分患儿临床转归较好,少数菌血症患儿可因脓毒性休克致死。

    Abstract:

    Objective To systematically evaluate the clinical characteristics of Streptococcus gallolyticus (SG) infection in children. Methods PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases were systematically retrieved, retrieval time was from database establishment to March 15, 2024. Case reports or case series reports of SG infection in children were included, while reviews, abstracts that couldn’t obtain the full text, and literatures outside of Chinese and English language were excluded. Two researchers independently evaluated the quality of the included literatures, extracted literature information, and summarized the clinical characteristics of SG infection by adopting Joanna Briggs Institute (JBI) quality evaluation tools. Results 35 literatures were included in analysis, involving 65 pediatric patients, including 40 males and 22 females, with 3 cases not reporting gender. The age of onset ranges from 20 hours to 3.5 years old. Bacteremia, bacterial meningitis, infective endocarditis, urinary tract infection, and liver abscess were 53, 38, 4, 2 cases, and 1 case, respectively. SG had a high susceptibility rate to penicillin (96.1%). Bacteremia and meningitis were often treated with monotherapy of penicillin G, ampicillin, or cefotaxime, with a few cases using two antimicrobial combination. Four cases of endocarditis were all treated with two antimicrobial combination, and one case of liver abscess was treated with three antimicrobial combination; 60 cases survived, 4 cases died, and 1 case had no reported clinical outcome. Seven children with meningitis developed neurological complications, and one child with endocarditis developed glomerulonephritis. Conclusion Low-age children is the main population of SG infection in children, especially neonate, with bacteremia and meningitis being the most common. Most children have good clinical outcomes, and minority of children with bacteremia may die from septic shock.

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王瑞丽,陶兴茹,邢亚兵.基于病例报告的儿童解没食子酸链球菌感染系统评价[J]. 中国感染控制杂志,2025,24(2):193-200. DOI:10.12138/j. issn.1671-9638.20256166.
WANG Ruili, TAO Xingru, XING Yabing.Streptococcus gallolyticus infection in children: a systematic review based on case reports[J]. Chin J Infect Control, 2025,24(2):193-200. DOI:10.12138/j. issn.1671-9638.20256166.

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  • 收稿日期:2024-02-28
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  • 在线发布日期: 2025-02-26
  • 出版日期: 2025-02-28