侵袭性人源猪链球菌感染的临床特征、90天功能结局、抗菌药物敏感性及探索性基因组分析：中国多中心回顾性研究
Clinical Characteristics, 90-Day Functional Outcomes, Antimicrobial Susceptibility, and Exploratory Genomic Analysis of Invasive Human Streptococcus suis Infection: A Multicenter Retrospective Study in China.
文献信息
| PMID | 42918323 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Huatang Zhang |
| 作者单位 | Department of Infection Disease, Clinical Medical Research Center for Bacterial and Fungal Infectious Diseases of Fujian province, Fujian Medical University Affiliated First Quanzhou hospital, No. 250 East Street, Licheng District, Quanzhou, Fujian 362000, China. |
| 期刊 | International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases |
| SCI 分区 | Q1 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 猪链球菌是一种人畜共患病原体；侵袭性感染幸存者可能存在持续性听觉或前庭后遗症。为弥补中国多中心证据的不足，我们描述了90天结局、抗菌药物敏感性及探索性基因组发现。
方法： 我们回顾性研究了2017年至2025年间在中国四个省份八家医院收治的34例侵袭性猪链球菌感染患者。不良结局定义为90天内死亡或第90天时存在持续性后遗症。最低抑菌浓度采用CLSI草绿色链球菌群替代折点重新判读；对6株可回收分离株进行了全基因组测序。
结果： 急性耳蜗前庭受累发生于11/27（40.7%）的脑膜炎患者和0/7的非脑膜炎型菌血症/脓毒症患者。不良结局发生于17/34（50.0%）患者，包括2例死亡；12/32（37.5%）幸存者存在听力相关后遗症。急性耳蜗前庭受累在不良结局患者中更为常见（64.7%对0%；P < 0.001）。所有可评估分离株对青霉素（21/21）、头孢噻肟（19/19）和头孢曲松（5/5）敏感。在接受红霉素、克林霉素和四环素检测的分离株中，分别有17/20、16/20和20/20观察到耐药。序列型为ST1（n = 3）、ST7（n = 2）和ST25（n = 1）；epf和sly各在5株分离株中检出，mrp在4株中检出。
结论： 显著的听力相关疾病负担支持开展结构化的听力学随访。临床关联和基因组发现仍属探索性，不能确立独立预后价值或基因型-表型因果关系。
英文摘要
BACKGROUND: Streptococcus suis is a zoonotic pathogen; survivors of invasive infection may have persistent auditory or vestibular sequelae. To address limited multicenter evidence from China, we characterized 90-day outcomes, antimicrobial susceptibility, and exploratory genomic findings.
METHODS: We retrospectively studied 34 patients with invasive S. suis infection at eight hospitals in four Chinese provinces (2017-2025). Unfavorable outcome was defined as death within 90 days or persistent sequelae at day 90. Minimum inhibitory concentrations were reinterpreted using CLSI viridans-group streptococcal surrogate breakpoints; six recoverable isolates underwent whole-genome sequencing.
RESULTS: Acute cochleovestibular involvement occurred in 11/27 (40.7%) patients with meningitis and 0/7 with nonmeningitic bacteremia/sepsis. Unfavorable outcomes occurred in 17/34 (50.0%) patients, including two deaths; 12/32 (37.5%) survivors had hearing-related sequelae. Acute cochleovestibular involvement was more frequent among patients with unfavorable outcomes (64.7% versus 0%; P < 0.001). All evaluable isolates were susceptible to penicillin (21/21), cefotaxime (19/19), and ceftriaxone (5/5). Resistance was observed in 17/20, 16/20, and 20/20 isolates tested for erythromycin, clindamycin, and tetracycline, respectively. Sequence types were ST1 (n = 3), ST7 (n = 2), and ST25 (n = 1); epf and sly were each detected in five isolates, and mrp in four.
CONCLUSIONS: Substantial hearing-related morbidity supports structured audiological follow-up. Clinical associations and genomic findings remain exploratory and do not establish independent prognostic value or genotype-phenotype causality.