López Sastre J B, Coto Cotallo G D, Fernández Colomer B
Department of Neonatology, Central Hospital de Asturias, Oviedo, Spain.
J Perinat Med. 2000;28(4):309-15. doi: 10.1515/JPM.2000.039.
A prospective multicenter study was designed to assess the epidemiology of neonatal sepsis of vertical transmission in Spain. The study was carried out by the "Grupo de Hospitales Castrillo" that included the neonatal services of 19 tertiary care (reference) hospitals and 9 secondary care hospitals. Prospective data from infants with culture-proved neonatal sepsis, clinical sepsis and bacteremia were recorded for 1995 to 1997. In a total of 203,288 neonates, proven sepsis was diagnosed in 515 (rate of 2.5 per 1000 live births), clinical sepsis in 724 (rate of 3.6 per 1000 live births), and bacteremia of vertical transmission in 155 (rate of 0.76 per 1000 live births). Very low birth weight (VLBW) infants (< or = 1500 g) showed a significantly higher incidence of confirmed sepsis (26.5 per 1000 live births) and clinical sepsis (32.4 per 1000 live births) than infants weighing > 1500 g. Streptococcus agalactiae was the most frequent causative pathogen in cases of proven sepsis (51%) and bacteremia (33%), but Escherichia coli was the most frequently recovered organism in the VLBW group. The mortality rate of proven sepsis was significantly higher than that of clinical sepsis (8.7% versus 4.3%) (P < 0.01). In the VLBW cohort, there were no significant differences in the mortality rate between proven sepsis and clinical sepsis. In conclusion, clinical sepsis was the most frequent diagnosis, probably related to intrapartum chemoprophylaxis. Streptococcus agalactiae was the most frequent causative pathogen of culture-positive sepsis and bacteremia, whereas E. coli was the most significant in VLBW infants.
一项前瞻性多中心研究旨在评估西班牙垂直传播新生儿败血症的流行病学情况。该研究由“卡斯蒂略医院集团”开展，纳入了19家三级医疗（参考）医院和9家二级医疗医院的新生儿服务部门。记录了1995年至1997年经培养证实的新生儿败血症、临床败血症和菌血症婴儿的前瞻性数据。在总共203288例新生儿中，确诊败血症515例（每1000例活产儿中有2.5例），临床败血症724例（每1000例活产儿中有3.6例），垂直传播菌血症155例（每1000例活产儿中有0.76例）。极低出生体重（VLBW）婴儿（≤1500克）确诊败血症（每1000例活产儿中有26.5例）和临床败血症（每1000例活产儿中有32.4例）的发生率显著高于体重＞1500克的婴儿。无乳链球菌是确诊败血症（51%）和菌血症（33%）病例中最常见的致病病原体，但在VLBW组中，大肠埃希菌是最常分离出的病原体。确诊败血症的死亡率显著高于临床败血症（8.7%对4.3%）（P＜0.01）。在VLBW队列中，确诊败血症和临床败血症的死亡率无显著差异。总之，临床败血症是最常见的诊断，可能与产时化学预防有关。无乳链球菌是培养阳性败血症和菌血症最常见的致病病原体，而大肠埃希菌在VLBW婴儿中最为重要。
