Streptococcus bovis infection in young infants
Streptococcus bovis infection in young infants
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DOI：
10.1097/01.inf.0000240334.91713.48
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发表时间：
2006-11-01
影响因子：
3.6
通讯作者：
Shah, Samir S.
中科院分区：
文献类型：
--
作者：
Gerber, Jeffrey S.;Glas, Mary;Shah, Samir S.
背景：在婴幼儿中有侵袭性牛链球菌病的零星病例报告。然而，很少有人知道的临床表现或条件，易患S。目的：本病例系列和文献回顾的目的是描述S。牛感染治疗的两个儿童医院，并比较病人在我们的机构评估与文献报道。牛感染在我们的机构治疗：4例患者有S。牛脑膜炎，其中3例还感染了S.牛菌血症其中5例患者在就诊时有胃肠道紊乱的体征。7例患者无死亡。23例S.文献中报告的牛感染包括脑膜炎伴菌血症（n = 9）、单纯菌血症（n = 9）、单纯脑膜炎（n = 4）和肺炎伴严重脓毒症（n = 1）。文献中报道的6例（26%）患者死于S。牛传染病我们的患者（14天;范围，1-43天）与文献报道的患者（3天;范围，1-60天）之间的中位年龄差异无统计学意义（P = 0.49）。在我们的系列中的患者（71%）比文献报道的患者（10%;比值比= 21.3; 95%置信区间= 1.7-319.0）更常见的腹胀。结论：菌血症和脑膜炎是最常见的表现。胃肠道功能紊乱是常见的患者在我们的系列。S.牛的感染率似乎低于以往报告的建议。
Background: Sporadic cases of invasive Streptococcus bovis disease have been reported in young infants. However, little is known about the clinical manifestations or the conditions that predispose to S. bovis infection in this population.Objective: The objective of this case series and review of the literature was to describe cases of S. bovis infection treated at 2 children's hospitals and compare patients evaluated at our institutions with those reported in the literature.Results: Seven infants with S. bovis infection were treated at our institutions: 4 of the patients had S. bovis meningitis and 3 of these also had S. bovis bacteremia. Five of the patients had signs of gastrointestinal disturbance at presentation. None of the 7 patients died. Twenty-three patients with S. bovis infection reported in the literature had meningitis with concurrent bacteremia (n = 9), bacteremia alone (n = 9), meningitis alone (n = 4), and pneumonia with overwhelming sepsis (n = 1). Six (26%) of the patients reported in the literature died as a consequence of S. bovis infection. The difference in median age between our patients (14 days; range, 1-43 days) and those reported in the literature (3 days; range, 1-60 days) was not statistically significant (P = 0.49). Abdominal distention was more commonly noted among patients in our series (71%) than among patients reported in the literature (10%; odds ratio = 21.3; 95% confidence interval = 1.7-319.0).Conclusions: Bacteremia and meningitis were the most common manifestations. Gastrointestinal disturbance was common among patients in our series. The mortality rate from S. bovis infection appears to be lower than suggested by previous reports.