早产儿迟发性血流感染：一项为期2年的调查。

Late-onset bloodstream infections in preterm infants: a 2-year survey.

作者信息

Grisaru-Soen Galia, Friedman Tal, Dollberg Shaul, Mishali Hagit, Carmeli Yehuda

机构信息

Pediatric Infectious Diseases Service, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.

出版信息

Pediatr Int. 2012 Dec;54(6):748-53. doi: 10.1111/j.1442-200X.2012.03679.x. Epub 2012 Sep 11.

DOI:10.1111/j.1442-200X.2012.03679.x

PMID:22672070

Abstract

BACKGROUND

We determined the prevalence and risk factors for late-onset bloodstream infections (LO-BSI), the distribution of pathogens and the outcomes of affected preterm infants.

METHODS

The records of all preterm infants (<37 weeks gestation) born between 2004 and 2005 and hospitalized in the neonatal intensive care unit for >3 days were retrieved for this retrospective matched case-control study.

RESULTS

A total of 108 out of 1459 preterm infants (7.4%) had 142 episodes of LO-BSI. The highest LO-BSI rate (44%) was among 198 very-low-birthweight infants (<1500 g). The most common causative organisms were Coagulase-negative staphylococci and Klebsiella (60% and 13%, respectively). The mean hospital stay was 64 days for LO-BSI preterm infants versus 48 days for non-LO-BSI preterm infants. Congenital malformations and peripheral catheters were independent risk factors for LO-BSI. Crude mortality rates were 6.9% (LO-BSI) and 3.0% (non-LO-BSI), with an LO-BSI-attributable mortality of 3.9%.

CONCLUSION

LO-BSI frequently affect very-low-birthweight infants. Strategies to prevent LO-BSI should target peripheral catheters.

摘要

背景

我们确定了晚发性血流感染（LO-BSI）的患病率和危险因素、病原体分布以及受影响早产儿的结局。

方法

检索2004年至2005年出生且在新生儿重症监护病房住院超过3天的所有早产儿（孕周<37周）的记录，进行这项回顾性匹配病例对照研究。

结果

1459例早产儿中共有108例（7.4%）发生了142次LO-BSI发作。LO-BSI发生率最高（44%）的是198例极低出生体重儿（<1500g）。最常见的病原体是凝固酶阴性葡萄球菌和克雷伯菌（分别为60%和13%）。发生LO-BSI的早产儿平均住院时间为64天，未发生LO-BSI的早产儿平均住院时间为48天。先天性畸形和外周导管是LO-BSI的独立危险因素。粗死亡率分别为6.9%（LO-BSI）和3.0%（非LO-BSI），LO-BSI导致的死亡率为3.9%。