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目的了解化脓链球菌致中毒性休克综合征(STSS)的实验室检查特征,为临床诊治和流行病学调查提供参考依据。方法回顾性分析1例化脓链球菌感染致STSS患者的临床诊治经过和实验室检查数据,对分离株进行emm基因分型,并检测其常见超抗原基因。结果该患者因左脚趾皮肤溃破致左下肢严重感染,并伴多器官功能衰竭及STSS。伤口分泌物分离出化脓链球菌,对青霉素敏感。分离株为emm 1.1型,携带speA、speC、spek、ssa和smeZ等5种超抗原基因。临床采取清创、负压封闭引流技术(VSD)和青霉素联合克林霉素抗感染等综合治疗,患者痊愈出院。结论化脓链球菌致STSS可引起严重的临床症状,与其携带多种超抗原基因有关。外科治疗和有效抗感染是保证治疗成功的关键。
Objective To understand the characteristics of laboratory tests of Streptococcus pyogenes-induced toxic shock syndrome (STSS) and provide a reference for clinical diagnosis and epidemiological investigation. Methods The clinical diagnosis and laboratory data of one STSS infection caused by streptococcus pyogenes were retrospectively analyzed. The isolates were subjected to emm genotyping and their common superantigen genes were detected. Results The patient suffered from severe left lower extremity infection due to ulceration of the left toe skin accompanied by multiple organ failure and STSS. Isolation of wound secretions of Streptococcus pyogenes, sensitive to penicillin. The isolates were emm 1.1 and carry 5 superantigen genes including speA, speC, spek, ssa and smeZ. Clinical debridement, vacuum closed drainage (VSD) and penicillin combined with clindamycin anti-infective and other comprehensive treatment, patients were discharged. Conclusion Streptococcus pyogenes STSS caused serious clinical symptoms, with its carrying a variety of superantigen genes. Surgical treatment and effective anti-infection is the key to successful treatment.