Zhao Qian, Chen Yan, Wang Yang, Xu Dou-Dou
Division of Neonatology, Department of Pediatrics, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2016 Apr;18(4):311-5. doi: 10.7499/j.issn.1008-8830.2016.04.006.
To study the clinical features and hospital costs of neonatal sepsis caused by Gram-positive (G(+)) bacteria, Gram-negative (G(-)) bacteria, and fungi.
The clinical data of 236 neonates with sepsis were analyzed retrospectively. Among these neonates, 110 had sepsis caused by G(+) bacteria, 68 had sepsis caused by G(-) bacteria, and 58 had sepsis caused by fungi.
Full-term infants accounted for 62% and 38%, respectively, in the G(+) bacteria and G(-) bacteria groups, and preterm infants accounted for 86% in the fungi group. The neonates in the fungi group had significantly lower gestational ages and birth weights than those in the G(+) and G(-) bacteria groups (P<0.05). Compared with the G(+) bacteria group, the G(-) bacteria and fungi groups had significantly higher rates of multiple births (P<0.0125). Compared with the G(+) bacteria and fungi groups, the rates of premature rupture of membranes >18 hours, grade III amniotic fluid contamination, and early-onset sepsis in the G(-) bacteria group were significantly higher (P<0.0125). Compared with the G(-) bacteria and fungi groups, the G(+) bacteria group showed significantly higher rates of abnormal body temperature, omphalitis or herpes as the symptom suggesting the onset of such disease (P<0.0125). The fungi group had significantly higher incidence rates of apnea and low platelet count than the G(+) and G(-) bacteria groups (P<0.0125). The comparison of length of hospital stay and total hospital costs between any two groups showed that the fungi group had a significantly longer hospital stay and significantly higher total hospital costs than the G(+) and G(-) bacteria groups (P<0.05).
Sepsis caused by G(+) bacteria mainly occurs in full-term infants, and most cases of sepsis caused by G(-) bacteria belong to the early-onset type. Sepsis caused by fungi is more common in preterm infants and low birth weight infants, and has high incidence rates of apnea and low platelet count, as well as a longer hospital stay and higher hospital costs than sepsis caused by bacteria.
研究革兰氏阳性（G(+)）菌、革兰氏阴性（G(-)）菌和真菌所致新生儿败血症的临床特征及住院费用。
回顾性分析236例败血症新生儿的临床资料。其中，110例由G(+)菌引起败血症，68例由G(-)菌引起败血症，58例由真菌引起败血症。
G(+)菌组和G(-)菌组中足月儿分别占62%和38%，真菌组中早产儿占86%。真菌组新生儿的胎龄和出生体重显著低于G(+)菌组和G(-)菌组（P<0.05）。与G(+)菌组相比，G(-)菌组和真菌组的多胎率显著更高（P<0.0125）。与G(+)菌组和真菌组相比，G(-)菌组胎膜早破>18小时、羊水Ⅲ度污染及早发型败血症的发生率显著更高（P<0.0125）。与G(-)菌组和真菌组相比，G(+)菌组体温异常、以脐炎或疱疹作为该病发病提示症状的发生率显著更高（P<0.0125）。真菌组呼吸暂停和血小板计数低的发生率显著高于G(+)菌组和G(-)菌组（P<0.0125）。任意两组之间住院时间和总住院费用的比较显示，真菌组的住院时间显著更长，总住院费用显著高于G(+)菌组和G(-)菌组（P<0.05）。
G(+)菌所致败血症主要发生于足月儿，G(-)菌所致败血症多数属于早发型。真菌所致败血症在早产儿和低出生体重儿中更为常见，呼吸暂停和血小板计数低的发生率高，与细菌所致败血症相比，住院时间更长，住院费用更高。
