2022年底侵入性细菌疾病的发病率增加
Sarah Kyne1, Doireann Ní Shíocháin2, Caoimhe McDonnell3
1General Paediatrics, Children's Health Ireland, Dublin, Ireland. kynes@tcd.ie.
European journal of pediatrics
|October 26, 2023
概括
儿童的侵入性细菌疾病在2022年底上升,死亡率和严重后果更高. 甲型链球菌是最常见的原因,突出显示儿童的风险增加.
科学领域:
- 儿童传染病 儿童传染病
- 细菌学 细菌学是一门学科.
- 公共卫生监督 公共卫生监督
背景情况:
- 侵袭性细菌疾病 (IBD) 在全球范围内对儿童发病率和死亡率作出重大贡献.
- 爱尔兰和其他国家在2022/23年冬季观察到IBD病例的增加,特别是侵袭性A组链球菌 (GAS).
- 社区获得的IBD在儿科患者群体中存在诊断和管理方面的挑战.
研究的目的:
- 分析2022年第四季度在儿童健康爱尔兰 (CHI) 医院入院的儿童中社区获得IBD的趋势.
- 将IBD在2022年第四季度的发病率,致病生物和临床结果与前四年 (2018-2021年第四季度) 进行比较.
- 为了识别特定的IBD表现,如和血液感染,以及相关的病原体.
主要方法:
- 在三个CHI医院进行了跨站点的回顾性分析.
- 收集了2022年10月1日至2022年12月31日期间入院的儿童的数据,符合社区获得IBD的病例定义.
- 病例数和结果与2018-2021年第四季度的汇总数据进行了比较.
主要成果:
- 在2022年第四季度,82名儿童符合病例定义,而在2018年至2021年第四季度,这一数字为97例.
- 最常见的病原体是A组链球菌 (GAS) (33%),其次是肺炎链球菌,脑膜炎菌和流感血球菌.
- 在2022年第四季度,9%的病例导致死亡,比2018-2021年的2%显著增加 (p<0.05).
- 在2022年 (p=0.003) 观察到儿科整体绩效类别 (POPC) 评分>1的更高率.
- 在2022年第四季度,头部,部和胸部的腹增加.
- 29%的病例涉及血液感染,27%的部感染,15%的内感染.
结论:
- 侵袭性细菌疾病,特别是由GAS引起的,在2022年第四季度增加,导致儿童的发病率和死亡率更高.
- 这些发现强调了需要加强监测和迅速临床识别儿童群体内IBD的需要.
- 严重结局的增加率,包括PICU入院和手术干预,突显了IBD在此期间的严重程度.
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