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早期新生儿败血症的危险因素。

Risk factors in early neonatal sepsis.

作者信息

Shah G S, Budhathoki S, Das B K, Mandal R N

机构信息

Department of Paediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2006 Apr-Jun;4(2):187-91.

Abstract

OBJECTIVE

To study the maternal and neonatal risk factors for neonatal sepsis.

MATERIALS AND METHODS

This is prospective case control study, conducted on the neonates up to 7 days of life with a diagnosis of neonatal sepsis. There were 100 cases of neonatal sepsis and 100 control cases. The neonates in the case and control groups were evaluated for various maternal and neonatal risk factors.

RESULTS

The factors which carried a significant risk for development of neonatal sepsis were premature rupture of membrane (PROM), meconium stained amniotic fluid (MSAF), foul smelling liquor, low birth weight, prematurity and low Apgar score at birth. The blood culture was positive in 22% of cases. The commonest organisms isolated were S. aureus and Klebsiella. The overall mortality was 11%. The incidence of risk factors was almost equal in culture positive and culture negative cases.

CONCLUSION

The study identifies PROM, MSAF, foul smelling amniotic fluid, prematurity, low birth weight and low Apgar score at birth as strong risk factors for development of neonatal sepsis. In the presence of above factors, the neonate should be screened and observed for sepsis and considered for early institution of antibiotics.

摘要

目的

研究新生儿败血症的母婴危险因素。

材料与方法

这是一项前瞻性病例对照研究,对出生7天内诊断为新生儿败血症的新生儿进行。有100例新生儿败血症病例和100例对照病例。对病例组和对照组的新生儿评估各种母婴危险因素。

结果

发生新生儿败血症的显著危险因素有胎膜早破(PROM)、羊水粪染(MSAF)、羊水有异味、低出生体重、早产和出生时阿氏评分低。22%的病例血培养呈阳性。分离出的最常见病原体是金黄色葡萄球菌和克雷伯菌。总死亡率为11%。培养阳性和培养阴性病例中危险因素的发生率几乎相等。

结论

该研究确定胎膜早破、羊水粪染、羊水有异味、早产、低出生体重和出生时阿氏评分低是新生儿败血症发生的强烈危险因素。在存在上述因素的情况下,应对新生儿进行败血症筛查和观察,并考虑早期使用抗生素。

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