Toxic shock syndrome in Australian children
Toxic shock syndrome in Australian children
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DOI：
10.1136/archdischild-2015-310121
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发表时间：
2016-08-01
影响因子：
5.2
通讯作者：
Curtis, Nigel
中科院分区：
文献类型：
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作者：
Chen, Katherine Y. H.;Cheung, Michael;Curtis, Nigel
背景描述儿童中毒性休克综合征（TSS）的流行病学、治疗和结局的数据有限，TSS是一种潜在的危及生命的疾病。在这里，我们描述的发病率，临床特征，治疗和结果的葡萄球菌和链球菌TSS的儿童在维多利亚，Australia.Methods回顾性图表审查的儿童承认之间的2003年和2014年的两个三级儿科转诊中心谁满足疾病控制和预防中心的TSS病例定义。葡萄球菌TSS 43例，链球菌TSS 19例。大多数病例（46例（74%））入住重症监护室，44例（71%）需要强心剂支持。与葡萄球菌TSS相比，链球菌TSS患者更年轻，更不适，更可能有残留的发病率。在58例（94%）病例中使用静脉注射免疫球蛋白或克林霉素辅助治疗，15例（24%）使用新鲜冷冻血浆。7例患者接受体外膜肺氧合。所有患者均存活。结论本研究强调了TSS的早期识别的重要性，并支持快速三级转诊和重症监护管理，其中包括使用静脉注射免疫球蛋白和克林霉素的连续治疗。
Background There are limited data describing the epidemiology, management and outcomes of children with toxic shock syndrome (TSS), a potentially life-threatening illness. Here, we describe the incidence, clinical features, treatment and outcome of children with staphylococcal and streptococcal TSS in Victoria, Australia.Methods Retrospective chart review of children admitted between 2003 and 2014 to two tertiary paediatric referral centres who fulfilled the Centers for Disease Control and Prevention case definition of TSS.Results There were 62 cases over the 11-year period; 43 staphylococcal TSS and 19 streptococcal TSS. The majority (46 (74%)) of cases were admitted to an intensive care unit and 44 (71%) required inotropic support. Compared with those with staphylococcal TSS, patients with streptococcal TSS were younger, more unwell and more likely to have residual morbidity. Adjunctive therapy with intravenous immunoglobulin or clindamycin was used in 58 (94%) of cases and fresh frozen plasma was used in 15 (24%). Seven patients received extracorporeal membrane oxygenation. All patients survived.Conclusions This study highlights the importance of early recognition of TSS and supports rapid tertiary referral and intensive care management, which includes the use of adjunctive therapy with intravenous immunoglobulin and clindamycin.