目的探究耐药肺结核合并咽炎患者多重耐药α-溶血性链球菌分子流行病学调查并构建风险模型。方法选择2019年3月-2022年1月在我院接受治疗的耐药肺结核合并咽炎患者150例为研究对象。采用PhoenixTM-100全自动细菌检测分析系统进行药敏试...目的探究耐药肺结核合并咽炎患者多重耐药α-溶血性链球菌分子流行病学调查并构建风险模型。方法选择2019年3月-2022年1月在我院接受治疗的耐药肺结核合并咽炎患者150例为研究对象。采用PhoenixTM-100全自动细菌检测分析系统进行药敏试验。依据脉冲场凝胶电泳(Pulsed field gel electrophoresis,PFGE)和多点位序列分析(Multilocus sequence type,MLST)技术对其中92例多重耐药草绿色链球菌(Viridans Group Streptococcus,VGS)感染患者进行分子流行病学调查。根据是否发生多重耐药感染将患者分为感染组(n=92)和非感染组(n=58),多因素Logistic分析多重耐药VGS感染的独立影响因素并构建简易评分模型划分感染风险等级并进行验证。结果药敏结果显示,VGS对亚胺培南、厄他培南的敏感性高,敏感率为100%;PFGE分型和MLST分型结果显示,92株多重耐药VGS菌株可分为5种PFGE克隆型和15种ST型;多因素Logistic分析结果表明,年龄、呕吐、腹泻、降钙素原、中性粒细胞、白细胞是导致耐药肺结核合并咽炎患者感染多重耐药VGS菌株的独立危险因素(P<0.05);年龄、白细胞、中性粒细胞和降钙素原与多重耐药VGS感染风险关联密切;简易评分模型结果显示其预测效能较好。结论年龄、降钙素原、中性粒细胞、白细胞是感染多重耐药VGS菌株关联最大的独立危险因素,为临床筛查和预防有多重耐药VGS感染风险的耐药肺结核合并咽炎患者提供了理论基础。展开更多
儿童慢性扁桃体炎是一种常见的上呼吸道慢性炎症性疾病,通常表现为扁桃体长期肿大、反复发作的炎症和伴随症状。其病因复杂,与反复急性扁桃体炎、免疫系统发育不完善、细菌或病毒感染等因素密切相关。临床症状包括咽喉不适、口臭、吞咽...儿童慢性扁桃体炎是一种常见的上呼吸道慢性炎症性疾病,通常表现为扁桃体长期肿大、反复发作的炎症和伴随症状。其病因复杂,与反复急性扁桃体炎、免疫系统发育不完善、细菌或病毒感染等因素密切相关。临床症状包括咽喉不适、口臭、吞咽困难、打鼾及睡眠呼吸暂停等,严重者可影响儿童的生长发育和生活质量。诊断基于病史、体征和实验室检查,治疗方法包括保守治疗和手术。本综述旨在系统梳理并分析近年来关于儿童慢性扁桃体炎(chronic tonsillitis, CTL)的研究进展,涵盖其流行病学特征、潜在的病因机制、临床表现的异质性、诊断的挑战与策略,以及目前推荐的治疗方法和预防措施的有效性,并探讨未来研究方向的可能性。Chronic tonsillitis in children is a common chronic inflammatory disease of the upper respiratory tract, usually characterized by prolonged enlargement of the tonsils, recurrent inflammation and accompanying symptoms. Its etiology is complex and closely related to factors such as recurrent acute tonsillitis, underdevelopment of the immune system, and bacterial or viral infections. Clinical symptoms include throat discomfort, bad breath, dysphagia, snoring and sleep apnea, which in severe cases can affect children’s growth and development and quality of life. Diagnosis is based on history, signs and laboratory tests, and treatment includes conservative treatment and surgery. The purpose of this review is to systematically review and analyze the research progress of chronic tonsillitis (CTL) in children in recent years, covering its epidemiological characteristics, potential etiological mechanisms, heterogeneity of clinical manifestations, diagnostic challenges and strategies, as well as the effectiveness of currently recommended treatments and preventive measures, and explore possibilities for future research directions.展开更多
文摘目的探究耐药肺结核合并咽炎患者多重耐药α-溶血性链球菌分子流行病学调查并构建风险模型。方法选择2019年3月-2022年1月在我院接受治疗的耐药肺结核合并咽炎患者150例为研究对象。采用PhoenixTM-100全自动细菌检测分析系统进行药敏试验。依据脉冲场凝胶电泳(Pulsed field gel electrophoresis,PFGE)和多点位序列分析(Multilocus sequence type,MLST)技术对其中92例多重耐药草绿色链球菌(Viridans Group Streptococcus,VGS)感染患者进行分子流行病学调查。根据是否发生多重耐药感染将患者分为感染组(n=92)和非感染组(n=58),多因素Logistic分析多重耐药VGS感染的独立影响因素并构建简易评分模型划分感染风险等级并进行验证。结果药敏结果显示,VGS对亚胺培南、厄他培南的敏感性高,敏感率为100%;PFGE分型和MLST分型结果显示,92株多重耐药VGS菌株可分为5种PFGE克隆型和15种ST型;多因素Logistic分析结果表明,年龄、呕吐、腹泻、降钙素原、中性粒细胞、白细胞是导致耐药肺结核合并咽炎患者感染多重耐药VGS菌株的独立危险因素(P<0.05);年龄、白细胞、中性粒细胞和降钙素原与多重耐药VGS感染风险关联密切;简易评分模型结果显示其预测效能较好。结论年龄、降钙素原、中性粒细胞、白细胞是感染多重耐药VGS菌株关联最大的独立危险因素,为临床筛查和预防有多重耐药VGS感染风险的耐药肺结核合并咽炎患者提供了理论基础。
文摘儿童慢性扁桃体炎是一种常见的上呼吸道慢性炎症性疾病,通常表现为扁桃体长期肿大、反复发作的炎症和伴随症状。其病因复杂,与反复急性扁桃体炎、免疫系统发育不完善、细菌或病毒感染等因素密切相关。临床症状包括咽喉不适、口臭、吞咽困难、打鼾及睡眠呼吸暂停等,严重者可影响儿童的生长发育和生活质量。诊断基于病史、体征和实验室检查,治疗方法包括保守治疗和手术。本综述旨在系统梳理并分析近年来关于儿童慢性扁桃体炎(chronic tonsillitis, CTL)的研究进展,涵盖其流行病学特征、潜在的病因机制、临床表现的异质性、诊断的挑战与策略,以及目前推荐的治疗方法和预防措施的有效性,并探讨未来研究方向的可能性。Chronic tonsillitis in children is a common chronic inflammatory disease of the upper respiratory tract, usually characterized by prolonged enlargement of the tonsils, recurrent inflammation and accompanying symptoms. Its etiology is complex and closely related to factors such as recurrent acute tonsillitis, underdevelopment of the immune system, and bacterial or viral infections. Clinical symptoms include throat discomfort, bad breath, dysphagia, snoring and sleep apnea, which in severe cases can affect children’s growth and development and quality of life. Diagnosis is based on history, signs and laboratory tests, and treatment includes conservative treatment and surgery. The purpose of this review is to systematically review and analyze the research progress of chronic tonsillitis (CTL) in children in recent years, covering its epidemiological characteristics, potential etiological mechanisms, heterogeneity of clinical manifestations, diagnostic challenges and strategies, as well as the effectiveness of currently recommended treatments and preventive measures, and explore possibilities for future research directions.
