Quiambao B P, Simoes E A F, Ladesma E A, Gozum L S, Lupisan S P, Sombrero L T, Romano V, Ruutu P J
Research Institute for Tropical Medicine, Manila, Philippines.
J Perinatol. 2007 Feb;27(2):112-9. doi: 10.1038/sj.jp.7211633. Epub 2007 Jan 18.
To determine the bacterial etiology, clinical presentation and risk factors for outcome of serious community-acquired infections in young infants.
Infants younger than 60 days, admitted for severe pneumonia or suspected sepsis/meningitis were prospectively evaluated using complete blood count, blood culture, chest radiograph, cerebrospinal fluid (CSF) culture in suspected meningitis. chi2 or Fisher's exact test and stepwise logistic regression were used for analysis.
Thirty-four of 767 enrolled infants had a positive blood or CSF culture. Gram-negative bacteria were more frequent than Gram positive: overall (P=0.004), in those below 7 days of age (P=0.002) and among home deliveries (P=0.012). Case fatality rates were higher among infants below 1 week old (OR 4.14, P<0.001), those with dense (OR 2.92, P<0.001) or diffuse radiographic infiltrates (OR 2.79, P=0.003).
Gram-negative enteric bacteria are the predominant causes of community-acquired infections in Filipino infants below 2 months old. Age below 7 days and radiographic pneumonia predicted death.
确定小婴儿严重社区获得性感染的细菌病因、临床表现及影响预后的危险因素。
前瞻性评估60日龄以下因重症肺炎或疑似败血症/脑膜炎入院的婴儿，进行全血细胞计数、血培养、胸部X光检查，疑似脑膜炎者进行脑脊液（CSF）培养。采用卡方检验或Fisher精确检验及逐步逻辑回归进行分析。
767名纳入研究的婴儿中，34名血培养或脑脊液培养呈阳性。革兰氏阴性菌比革兰氏阳性菌更常见：总体情况（P = 0.004），7日龄以下婴儿（P = 0.002）及在家分娩的婴儿中（P = 0.012）。1周龄以下婴儿（比值比4.14，P < 0.001）、胸片有致密影（比值比2.92，P < 0.001）或弥漫性浸润影（比值比2.79，P = 0.003）的婴儿病死率更高。
革兰氏阴性肠道细菌是菲律宾2月龄以下婴儿社区获得性感染的主要病因。7日龄以下及胸片显示肺炎是死亡的预测因素。
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