Turhan Esma Ebru, Gürsoy Tuğba, Ovalı Fahri
Neonatal Intensive Care Unit, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, İstanbul, Turkey.
Turk Pediatri Ars. 2015 Sep 1;50(3):170-5. doi: 10.5152/TurkPediatriArs.2015.2627. eCollection 2015 Sep.
Neonatal sepsis is an important cause of mortality and morbidity in newborns. The causative agents may be different in different units and may change in time. It was aimed to examine the microbiological agents leading to sepsis, clinical features and antibiotic resistances in babies with sepsis hospitalized in our unit in a two-year period.
The clinical features, microbiological and laboratory results, antibiotic resistance patterns and mortality rates of the newborns with sepsis followed up in our unit between 2010 and 2011 were examined in the patient record system.
351 babies diagnosed with sepsis among 3219 patients hospitalized in the neonatal intensive care unit were included in the study. The mean gestational age was found to be 30.1±4.1 weeks, the mean birth weight was found to be 1417.4±759.1 g and the mean hospitalization time was found to be 43.6±34.4 days. Blood cultures were found to be positive in 167 (47.6%) patients, urine cultures were found to be positive in 6 (7.1%) patients and cerebrospinal fluid cultures were found to be positive in 34 (9.6%) cases. Candida grew in 5 patients (2 patients with early-onset sepsis and 3 patients with late-onset sepsis). The most common cause of sepsis was found to be staphylococci (coagulase negative staphylococcus was found in 65 patients (51%) and Staphylococcus aureus was found in 38 patients (39%). 49.6% (n=63) of the gram positive bacteriae and 60% (n=21) of the gram negative bacteriae were resistant to antibiotics. Six (7.1%) of the patients who were infected with these bacteriae were lost. In total 24 babies were lost because of sepsis. The bacteriae which caused to mortality with the highest rate included E. coli, coagulase negative staphylocicci, S. aureus and Klebsiella. Low birth weight, mechanical ventilation and parenteral nutrition were found to be significant risk factors in terms of mortality.
Staphylococci were found to be the most common agents in neonatal sepsis. Low birth weight, mechanical ventilation and parenteral nutrition are significant risk factors in terms of mortality.
新生儿败血症是新生儿死亡和发病的重要原因。不同单位的致病因子可能不同，且会随时间变化。本研究旨在调查我院两年内住院败血症患儿的微生物病原体、临床特征及抗生素耐药情况。
在患者记录系统中检查了2010年至2011年间在我院接受随访的败血症新生儿的临床特征、微生物学和实验室结果、抗生素耐药模式及死亡率。
新生儿重症监护病房收治的3219例患者中，351例被诊断为败血症并纳入研究。平均胎龄为30.1±4.1周，平均出生体重为1417.4±759.1克，平均住院时间为43.6±34.4天。167例（47.6%）患者血培养呈阳性，6例（7.1%）患者尿培养呈阳性，34例（9.6%）患者脑脊液培养呈阳性。5例患者培养出念珠菌（2例早发型败血症患者和3例晚发型败血症患者）。败血症最常见的病因是葡萄球菌（65例（51%）患者为凝固酶阴性葡萄球菌，38例（39%）患者为金黄色葡萄球菌）。49.6%（n=63）的革兰氏阳性菌和60%（n=21）的革兰氏阴性菌对抗生素耐药。感染这些细菌的患者中有6例（7.1%）死亡。因败血症死亡的患者中，死亡率最高的细菌包括大肠杆菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌和克雷伯菌。低出生体重、机械通气和肠外营养是导致死亡的重要危险因素。
葡萄球菌是新生儿败血症最常见的病原体。低出生体重、机械通气和肠外营养是导致死亡的重要危险因素。
