西班牙儿科急诊中的沙门氏菌菌血症:不常见但并不轻微

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Pediatric Infectious Disease Journal Pub Date : 2024-09-01 Epub Date: 2024-04-30 DOI:10.1097/INF.0000000000004379
María Garrido Rodríguez, José Antonio Alonso-Cadenas, Borja Gómez, Iker Gangoiti, Susanna Hernández-Bou, Mercedes de la Torre Espí
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引用次数: 0

摘要

背景:虽然沙门氏菌是发展中国家血液培养中最常见的致病菌,但在我们的环境中,沙门氏菌是儿科患者血液感染中不常见的微生物:在发展中国家,沙门氏菌是血液培养物中最常见的致病菌,但在我国儿童患者中,沙门氏菌是一种不常见的血流感染微生物:方法:我们描述了到儿科急诊就诊并被诊断为沙门氏菌菌血症(SB)的儿童,并通过双变量分析确定了不良预后(即并发症、后遗症和死亡)的临床和实验室预测因素。我们进行了一项观察性研究和一项多中心前瞻性登记的子分析,包括患者 结果:在 55 例 SB 患者(占登记菌血症的 3.2%)中,32 例(58.2%)无 SB 危险因素,42 例(76.3%)儿科三角区评估正常,45 例(81.8%)伴有胃肠道感染(急性胃肠炎或肠道热)。9例(16.4%)预后不佳,其中1例死亡(1.8%)。儿科评估三角异常[几率比(OR):51.6;95% 置信区间(CI):9.2-289.5]、体格检查改变(OR:15.2;95% CI:4.4-58.8)和 C 反应蛋白升高(OR:1.01;95% CI:1.005-1.03)的患者更容易出现不良预后:大多数 SB 与胃肠道感染有关。结论:大多数 SB 都与胃肠道感染有关,每 6 名患儿中就有 1 名预后不佳;到达时儿科三角区评估异常(25% 的患者)是主要的风险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Salmonella Bacteremia in Spanish Pediatric Emergency Departments: Uncommon But Not Mild.

Background: Salmonella spp. is an uncommon microorganism in bloodstream infections among pediatric patients in our setting, although in developing countries it is the most common causative organism in blood cultures.

Methods: We describe the children presenting to pediatric emergency departments and diagnosed with Salmonella bacteremia (SB) and identify clinical and laboratory predictors of poor outcome (ie, complications, sequelae and death) by bivariate analysis. We performed an observational study and subanalysis of a multicenter prospective registry, including patients <18 years of age with a positive blood culture obtained at any of the 22 participating Spanish pediatric emergency departments between 2011 and 2016. We considered young age, chronic diseases, immunosuppressive treatment and intestinal flora disruption as risk factors for SB.

Results: Of the 55 patients with SB (3.2% of registered bacteremia), 32 (58.2%) had no risk factors for SB, 42 (76.3%) had a normal pediatric assessment triangle and 45 (81.8%) an associated gastrointestinal infection (acute gastroenteritis or enteric fever). Nine (16.4%) had a poor outcome, including 1 death (1.8%). A poor outcome was more common in patients with an abnormal pediatric assessment triangle [odds ratio (OR): 51.6; 95% confidence interval (CI): 9.2-289.5], an altered physical examination (OR: 15.2; 95% CI: 4.4-58.8) and elevated C-reactive protein (OR: 1.01; 95% CI: 1.005-1.03).

Conclusions: Most SBs were related to a gastrointestinal infection. One in 6 children had a poor outcome; abnormal pediatric assessment triangle on arrival (25% of patients) was the main risk factor identified.

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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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