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題 名 | Group C Streptococcal Bacteremia: A Retrospective Clinical and Microbiological Analysis of 16 Cases=C群鏈球菌菌血症:一教學醫院16例之臨床與微生物學分析 |
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作 者 | 陳彥旭; 萬樹人; 李欣蓉; 黃文貴; 林錫勳; 王堯顯; 陳垚生; 王任賢; 顏慕庸; 劉永慶; | 書刊名 | 微免與感染雜誌 |
卷 期 | 31:1 1998.03[民87.03] |
頁 次 | 頁51-57 |
分類號 | 414.83 |
關鍵詞 | C群鏈球菌菌血症; Group C streptococci; Bacteremia; |
語 文 | 英文(English) |
中文摘要 | C群鏈球菌為β-溶血之鏈球菌,為動物感染常見之致病菌。對人類而言,其常植 生於皮膚、鼻咽黏膜、陰道等,但過去卻很少造成人類之疾病。近年來由於鑑定能力之進步、 免疫功能異常病人之增加,此類感染有增加之趨勢,且其於人體造成相當多樣化之感染症狀。 在1992年至1996年間,我們收集16例高雄榮民總醫院住院之C群鏈球菌菌血症病人,作一 回溯性臨床與微生物學方面之分析。除了一位小孩外,大部份病人為老年人(平均年齡61.6 ±19.5歲,由1個月至81歲),且具有多樣化、嚴重之原在疾病(87.5%),其中以癌症(37%)、 肝臟疾病(37%)、醣尿病(25%)、腦血管疾病(18%)佔大多數。臨床之症狀以發燒(87.5%)、厭 食(81.3%)、疲倦(43.8%)和畏寒(43.8%)為主。呼吸道(31.3%;上呼吸道[3/5]、下呼吸道[2/5]) 為主要之感染來源,其次為腸胃道(12.5%)與生殖泌尿系統(12.5%),另有一例為疑似感染性心 內膜炎、一例來自皮膚、四例無明顯之感染源。菌種方面,S. equisimilis是主要之菌種 (87.5%),其次為S. equi(6.2%)、S. dysgalactiae(6.2%),但未分離出S. zooepidemicus。 整體死亡率為31%,其中四位具有原在疾病。根據藥物感受性試驗之結果,penicillin仍是 首選藥物,但其耐受性之菌種亦不少(Resistantstrain,1/16; Intermediate susceptible strains,3/16)。Cefazolin, ampicillin, chloramphenicol則為不錯之替代藥物。C群鏈球 菌雖不是常見之致病菌,但近年來有增加之趨勢,且其多樣化感染與高死亡率,都需要臨床上 的注意與進一步之研究。 |
英文摘要 | Lancefield group C streptococci cause common infection in various animals, but infrequently in humans, although they colonize healthy individuals. The invasive diseases are rarer in humans. Sixteen cases of bacteremia due to group C streptococci were studied in a retrospective survey of a recent 5-year period at the Veterans General Hospital-Kaohsiung. Most patients were elderly (mean age: 61.6 ±19.5, ranging from 1 month to 81 years of age), and had underlying diseases (88%), predominantly malignancy (37%), liver diseases (37%), diabetes (25%). Only two patients (13%) had no underlying diseases. The probable sources of infection were the respiratory tract (31.3%), gastrointestinal tract (12.5%). genitourinary tract (12.5%), one infective endocarditis and cutaneous infection. There were four cases (25%) without obvious sources. Of the streptococcal isolates, S. equisimilis was the predominant organism (87.5%), with the other species being S. equi (6.2%) and S. dysgalacia (6.2%). The overall mortality rate was high (31%), which may reflect the patients underlying state and severity of infection. The antimicrobial agent of choice for infections due to group C streptococci is penicillin G, but penicillin tolerance may occur and may be responsible for the slow response to penicillin therapy, especially in severe infection. |
本系統中英文摘要資訊取自各篇刊載內容。