Javed Muhammad, Memon Abdul-Majid
Department of Pediatrics, Hamdard College of Medicine and Dentistry, Hamdard University Hospital, Taj Medical Complex M.A, Jinnah Road, Karachi, Pakistan.
Saudi Med J. 2009 Oct;30(10):1301-4.
To study the maternal risk factors in blood culture proven cases of early neonatal sepsis, and study the isolates and the sensitivity of these isolates.
This is a case series of all mothers admitted from January 2008 to December 2008 and registered on a pre-designed Proforma, by the House Officers, and Resident Medical Officers of Hamdard College of Medicine & Dentistry, Hamdard University Hospital, Karachi, Pakistan. All neonates delivered at the hospital were examined; first immediately at birth, and then daily until the mother was discharged after 2 to 3 days. Neonates with suspected sepsis were included in the study, blood examination, and blood cultures were obtained, maternal information such as social status, education, fever at the time of labor, use of antibiotics before delivery, onset of labor, and mode of delivery were studied in these cultures proven cases of neonatal sepsis. Antibiotics such as cefotaxime and amikacin were started on an empirical basis until final cultures reports were received. In cases of negative cultures, antibiotics were stopped, otherwise, they were continued according to culture and sensitivity for 10-14 days.
The total number of deliveries at Hamdard University Hospital from January 2008 to December 2008 was 950. Neonates with suspected sepsis comprised 257. Among these 257 cases, 113 neonates had positive blood cultures. Staphylococcus aureus being the most common organism in our study (59.2%) followed by Klebsiella pneumoniae (19.4%) and Enterococci (19.4%).
This study indicates that the presence of multiple maternal risk factors makes a child more susceptible to early onset neonatal sepsis.
研究血培养确诊的早发型新生儿败血症病例中的母亲风险因素,并研究分离菌株及其敏感性。
这是一个病例系列研究,纳入了2008年1月至2008年12月在巴基斯坦卡拉奇哈姆达德大学医院哈姆达德医学院及牙科学院的住院医师和住院医官按照预先设计的表格登记入院的所有母亲。对在该医院分娩的所有新生儿进行检查,出生后立即检查一次,之后每天检查,直至母亲在2至3天后出院。疑似败血症的新生儿被纳入研究,进行血液检查并采集血培养样本,在这些血培养确诊的新生儿败血症病例中研究母亲的社会地位、教育程度、分娩时发热情况、分娩前使用抗生素情况、分娩发动情况及分娩方式等信息。在收到最终培养报告之前,经验性使用头孢噻肟和阿米卡星等抗生素。如果培养结果为阴性,则停用抗生素,否则根据培养和药敏结果持续使用10 - 14天。
2008年1月至2008年12月哈姆达德大学医院的分娩总数为950例。疑似败血症的新生儿有257例。在这257例病例中,113例新生儿血培养呈阳性。金黄色葡萄球菌是我们研究中最常见的病原体(59.2%),其次是肺炎克雷伯菌(19.4%)和肠球菌(19.4%)。
本研究表明,多种母亲风险因素的存在使儿童更易患早发型新生儿败血症。