Division of Child Health, St George's, University of London, Cranmer Terrace, London, UK.
Arch Dis Child Fetal Neonatal Ed. 2011 Jan;96(1):F9-F14. doi: 10.1136/adc.2009.178798. Epub 2010 Sep 27.
Neonatal infection is an important cause of morbidity and mortality. Neonatal infection surveillance networks are necessary for defining the epidemiology of infections and monitoring changes over time.
Prospective multicentre surveillance using a web-based database.
12 English neonatal units.
Newborns admitted in 2006-2008, with positive blood, cerebrospinal fluid or urine culture and treated with antibiotics for at least 5 days.
Incidence, age at infection, pathogens and antibiotic resistance profiles.
With the inclusion of coagulase negative Staphylococci (CoNS), the incidence of all neonatal infection was 8/1000 live births and 71/1000 neonatal admissions (2007-2008). The majority of infections occurred in premature (<37 weeks) and low birthweight (<2500 g) infants (82% and 81%, respectively). The incidence of early onset sepsis (EOS; ≤48 h of age) was 0.9/1000 live births and 9/1000 neonatal admissions, and group B Streptococcus (58%) and Escherichia coli (18%) were the most common organisms. The incidence of late onset sepsis (LOS; >48 h of age) was 3/1000 live births and 29/1000 neonatal admissions (7/1000 live births and 61/1000 admissions including CoNS) and the most common organisms were CoNS (54%), Enterobacteriaceae (21%) and Staphylococcus aureus (18%, 11% of which were methicillin resistant S aureus). Fungi accounted for 9% of LOS (72% Candida albicans). The majority of pathogens causing EOS (95%) and LOS (84%) were susceptible to commonly used empiric first line antibiotic combinations of penicillin/gentamicin and flucloxacillin/gentamicin, respectively (excluding CoNS).
The authors have established NeonIN in England and defined the current epidemiology of neonatal infections. These data can be used for benchmarking among units, international comparisons and as a platform for interventional studies.
新生儿感染是发病率和死亡率的重要原因。新生儿感染监测网络对于确定感染的流行病学和监测随时间的变化是必要的。
使用基于网络的数据库进行前瞻性多中心监测。
12 家英国新生儿病房。
2006-2008 年入院、血、脑脊液或尿培养阳性且至少接受 5 天抗生素治疗的新生儿。
发病率、感染年龄、病原体和抗生素耐药谱。
包括凝固酶阴性葡萄球菌（CoNS）在内，所有新生儿感染的发病率为 1000 例活产儿中有 8 例（2007-2008 年为 1000 例新生儿入院中有 71 例）。大多数感染发生在早产儿（<37 周）和低出生体重儿（<2500g）（分别为 82%和 81%）。早发性败血症（EOS；≤48 小时）的发病率为 1000 例活产儿中有 0.9 例（1000 例新生儿入院中有 9 例），B 群链球菌（58%）和大肠杆菌（18%）是最常见的病原体。晚发性败血症（LOS；>48 小时）的发病率为 1000 例活产儿中有 3 例（1000 例新生儿入院中有 29 例（包括 CoNS 为 1000 例入院中有 7 例），最常见的病原体为 CoNS（54%）、肠杆菌科（21%）和金黄色葡萄球菌（18%，其中耐甲氧西林金黄色葡萄球菌占 11%）。真菌占 LOS 的 9%（72%为白色念珠菌）。引起 EOS（95%）和 LOS（84%）的病原体大多数对青霉素/庆大霉素和氟氯西林/庆大霉素常用的一线经验性抗生素联合治疗敏感（不包括 CoNS）。
作者在英国建立了 NeonIN，并确定了新生儿感染的当前流行病学。这些数据可用于各单位间的基准比较、国际比较和作为干预研究的平台。
