Jiang Yongmei, Kuang Linghan, Wang Haijuan, Li Lingping, Zhou Wei, Li Mingyuan
Microbiology Teaching and Research Section, West China School of Preclinical and Forensic Medicine, Sichuan University, China.
Intern Med. 2016;55(6):597-603. doi: 10.2169/internalmedicine.55.3930. Epub 2016 Mar 15.
To identify the pathogens responsible for neonatal sepsis in a high-volume women and children's hospital in Southwest China.
We retrospectively studied 133 neonates who were admitted to the West China Women and Children's Hospital between 2008 and 2012 for sepsis. The clinical characteristics of the patients were recorded, and the antibiotic sensitivities of the isolated bacteria were determined.
All of the included patients had clinical symptoms of sepsis, and subsequent blood cultures confirmed the infection. Almost 80% of patients were infected with coagulase-negative staphylococci (52.8%), Escherichia coli (23.6%), Klebsiella pneumoniae (16.0%) or Staphylococcus aureus (7.5%). Neonates who were infected with gram-negative bacteria, particularly K. pneumoniae, had lower birth weights and were admitted to hospital within 24 hours of birth. Additionally, 87.5% of the isolated K. pneumoniae strains were resistant to third generation cephalosporins.
Coagulase-negative staphylococci were the most common pathogens found in neonatal sepsis. Moreover, neonatal sepsis caused by gram-negative bacteria was more often observed in newborns of low birth weight. The isolated strains of gram-negative bacteria were highly resistant to cephalosporins. This observation highlights the issue of antibiotic-resistant pathogens in the clinical setting, which poses an added risk to infants presenting with sepsis.
确定中国西南部一家大型妇女儿童医院新生儿败血症的病原体。
我们回顾性研究了2008年至2012年间因败血症入住华西妇女儿童医院的133例新生儿。记录患者的临床特征，并测定分离细菌的抗生素敏感性。
所有纳入患者均有败血症临床症状，随后血培养证实感染。近80%的患者感染凝固酶阴性葡萄球菌（52.8%）、大肠杆菌（23.6%）、肺炎克雷伯菌（16.0%）或金黄色葡萄球菌（7.5%）。感染革兰氏阴性菌（尤其是肺炎克雷伯菌）的新生儿出生体重较低，且在出生后24小时内入院。此外，分离出的肺炎克雷伯菌菌株中有87.5%对第三代头孢菌素耐药。
凝固酶阴性葡萄球菌是新生儿败血症中最常见的病原体。此外，低出生体重新生儿中革兰氏阴性菌引起的新生儿败血症更为常见。分离出的革兰氏阴性菌菌株对头孢菌素高度耐药。这一观察结果凸显了临床环境中抗生素耐药病原体的问题，这给患有败血症的婴儿带来了额外风险。
