朱其荣 1王川林 1刘娇 1古雪 1梅怡晗 2杜秋霞 3梅小平1
作者信息
- 1. 川北医学院附属医院感染科,四川南充637000
- 2. 首都医科大学,北京100069
- 3. 四川省疾病预防控制中心,四川成都610041
- 折叠
摘要
Abstract
Objective To explore the clinical features of children with severe hand,foot and mouth disease caused by human Enterovirus 71 (EV71) and its risk factors for infection,and provide reference for the prevention,clinical diagnosis and therapy.Methods The clinical data of 67 children with severe hand,foot and mouth disease between January 2013 and December 2015 were retrospectively analyzed using the method of descriptive epidemiological analysis.At the same time,the patients' general information,symptoms,signs and auxiliary examination and outcome were retrospectively analyzed;the infected sites,type of bacteria and drug sensitivity test results were collected.qRT-PCR was used to test conventional type of Enterovirus (EV),Enterovirus 71 (EV71),and Coxsackie virus A16 (A16).Results Of the 67 children with severe hand,foot and mouth disease,34 cases were only infected by EV71 (50.7％),and 33 patients had EV71 mixed infection (49.3％).Secondary infections most commonly appeared in the lower respiratory tract (26.5％).There were 46 strains of pathogens isolated in clinic,of which 11 strains were Grampositive bacteria (23.9％) and 35 strains were Gram-negative bacteria (76.1％).Drug susceptibility tests revealed that Gram-negative bacteria were generally sensitive to Ceftriaxone,Imipenem,Cefoperazone and Sulbactam,while Gram-positive bacteria were generally sensitive to Cefazolin sodium,Piperacillin and Vancomycin.EV71 type severe hand,foot and mouth disease was often seen in boys under 3 years of age,rarely occurred in children over the age of 5.The peak onset was in spring and summer,The clinical symptoms mainly included high fever,rash,drowsiness,hyperarousal,limb jitter and positive pathological signs,often accompanied by abnormalities in chest radiograph and cranial CT.The experimental results showed markedly increased myocardial enzymes,liver function indexes,WBC and blood glucose,and abnormal humoral immunity and procalcitonin.Male children under the age of 3,children with poor rural housing condition and bad health habits,and children without taking preventive measures for the disease because the guardians had no knowledge of the disease were the high-risk groups for the disease,the common pathogen of infection was EV71.Conclusions In some areas of Sichuan,severe hand,foot and mouth disease in children is mainly caused by EV71 infection and EV71 mixed Enterovirus infection.Understanding the clinical characteristics of severe hand,foot and mouth disease and knowing well the risk factors are of great significance for the prevention and control of the disease.关键词
重症手足口病/人肠道病毒71型/临床特征/危险因素Key words
severe hand, foot and mouth disease/Enterovirus type 71/clinical feature/risk factor分类
医药卫生
