Kohli-Kochhar Ruchika, Omuse Geoffrey, Revathi Gunturu
Division of Microbiology, Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya.
J Infect Dev Ctries. 2011 Nov 15;5(11):799-803. doi: 10.3855/jidc.1674.
Neonatal mortality in developing countries is usually due to an infectious cause. The gold standard of investigation in developing countries is a positive blood culture. It is important to know the aetiology of neonatal bloodstream infections so that empiric treatment can be effective.
We conducted a retrospective clinical audit over ten years between January 2000 until December 2009, looking at the aetiology of both early and late onset neonatal sepsis. We analysed data from 152 (23%) patient isolates out of 662 suspected cases of neonatal sepsis.
Our study revealed that Gram-positive organisms were the predominant cause of both early and late onset sepsis; the common isolates were Staphylococcus epidermidis (34%) and Staphylococcus aureus (27%). There were no isolates of group B Streptococcus. Candida species was isolated only in patients with late onset sepsis (6.9%). Bacterial isolates were relatively sensitive to the commonly used first- and second-line empiric antibiotics.
Gram-positive organisms remain the major cause of neonatal bloodstream infections in our setup. The findings of this study will guide clinicians in prescribing the right empiric therapy in cases of suspected neonatal sepsis before the definitive culture results are obtained.
发展中国家的新生儿死亡率通常归因于感染性病因。在发展中国家,调查的金标准是血培养呈阳性。了解新生儿血流感染的病因很重要,这样经验性治疗才能有效。
我们对2000年1月至2009年12月这十年间进行了一项回顾性临床审计,观察早发型和晚发型新生儿败血症的病因。我们分析了662例疑似新生儿败血症病例中152例(23%)患者分离株的数据。
我们的研究表明,革兰氏阳性菌是早发型和晚发型败血症的主要病因;常见的分离株是表皮葡萄球菌(34%)和金黄色葡萄球菌(27%)。没有B族链球菌分离株。念珠菌属仅在晚发型败血症患者中分离到(6.9%)。细菌分离株对常用的一线和二线经验性抗生素相对敏感。
在我们的研究中,革兰氏阳性菌仍然是新生儿血流感染的主要原因。本研究结果将指导临床医生在获得明确培养结果之前,对疑似新生儿败血症病例开具正确的经验性治疗方案。