Evidence of streptococcal origin of acute non-necrotising cellulitis: a serological study
Evidence of streptococcal origin of acute non-necrotising cellulitis: a serological study
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DOI：
10.1007/s10096-014-2274-9
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发表时间：
2015-04-01
影响因子：
4.5
通讯作者：
Syrjanen, J.
中科院分区：
文献类型：
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作者：
Karppelin, M.;Siljander, T.;Syrjanen, J.
急性蜂窝组织炎很少实现细菌学诊断。 β-溶血性链球菌和金黄色葡萄球菌被认为是主要病原体。然而，后者在非化脓性蜂窝织炎病例中的作用尚不清楚。我们进行了一项血清学研究，以调查急性非坏死性蜂窝织炎的细菌病因。抗链球菌溶血素 O (ASO)、抗脱氧核糖核酸酶 B (ADN) 和抗葡萄球菌溶血素 (ASTA) 滴度通过 77 名因急性细菌性非坏死性蜂窝组织炎住院的患者的急性期和恢复期血清以及 89 名年龄和性别匹配的对照受试者的血清样本进行测定。还审查了抗生素治疗决定。 77 例中有 53 例 (69%) 链球菌血清学呈阳性。此外，10例没有链球菌感染血清学证据的病例也成功接受了青霉素治疗。 89 名对照者中，分别有 10 名 (11%) 和 3 名 (3%) 检测到阳性 ASO 和 ADN 滴度，3 名患者和 11 名对照者的 ASTA 升高。我们的研究结果表明，不形成脓液的急性非坏死性蜂窝织炎大多是链球菌起源的，青霉素可以作为大多数患者的一线治疗。
Bacteriological diagnosis is rarely achieved in acute cellulitis. Beta-haemolytic streptococci and Staphylococcus aureus are considered the main pathogens. The role of the latter is, however, unclear in cases of non-suppurative cellulitis. We conducted a serological study to investigate the bacterial aetiology of acute non-necrotising cellulitis. Anti-streptolysin O (ASO), anti-deoxyribonuclease B (ADN) and anti-staphylolysin (ASTA) titres were measured from acute and convalescent phase sera of 77 patients hospitalised because of acute bacterial non-necrotising cellulitis and from the serum samples of 89 control subjects matched for age and sex. Antibiotic treatment decisions were also reviewed. Streptococcal serology was positive in 53 (69 %) of the 77 cases. Furthermore, ten cases without serological evidence of streptococcal infection were successfully treated with penicillin. Positive ASO and ADN titres were detected in ten (11 %) and three (3 %) of the 89 controls, respectively, and ASTA was elevated in three patients and 11 controls. Our findings suggest that acute non-necrotising cellulitis without pus formation is mostly of streptococcal origin and that penicillin can be used as the first-line therapy for most patients.