印度农村地区的新生儿败血症：在社区环境中进行的一项基于人群的前瞻性研究中的发病时间、微生物学及抗生素耐药性
Neonatal sepsis in rural India: timing, microbiology and antibiotic resistance in a population-based prospective study in the community setting.
作者信息
Panigrahi P, Chandel D S, Hansen N I, Sharma N, Kandefer S, Parida S, Satpathy R, Pradhan L, Mohapatra A, Mohapatra S S, Misra P R, Banaji N, Johnson J A, Morris J G, Gewolb I H, Chaudhry R
机构信息
Department of Epidemiology and Pediatrics, Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Environmental, Agricultural, &Occupational Health, Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
出版信息
J Perinatol. 2017 Aug;37(8):911-921. doi: 10.1038/jp.2017.67. Epub 2017 May 11.
OBJECTIVE
To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting.
STUDY DESIGN
All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture.
RESULTS
Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old. Culture-confirmed incidence of sepsis was 6.7/1000 births with 51% Gram negatives (Klebsiella predominating) and 26% Gram positives (mostly Staphylococcus aureus). A very high level of resistance to penicillin and ampicillin, moderate resistance to cephalosporins and extremely low resistance to Gentamicin and Amikacin was observed.
CONCLUSION
The bacterial burden of sepsis in the Indian community is not high. Judicious choice of empiric antibiotics, antibiotic stewardship and alternate modalities should be considered for the management or prevention of neonatal sepsis in India.
目的
在印度社区环境下进行的一项基于人群的监测中，研究新生儿败血症的发病时间和微生物学情况。
研究设计
对奥里萨邦223个村庄的所有活产婴儿进行为期60天的家庭随访。疑似败血症病例被转诊至研究医院进行包括血培养在内的进一步评估。
结果
在12622例出生婴儿中，842例因疑似败血症入院，其中95%的婴儿年龄在4至60天之间。败血症的血培养确诊发病率为6.7/1000例出生婴儿，其中革兰氏阴性菌占51%（以克雷伯菌为主），革兰氏阳性菌占26%（主要是金黄色葡萄球菌）。观察到对青霉素和氨苄西林的耐药水平很高，对头孢菌素的耐药性中等，对庆大霉素和阿米卡星的耐药性极低。
结论
印度社区败血症的细菌负担不高。在印度，对于新生儿败血症的管理或预防，应考虑明智地选择经验性抗生素、抗生素管理及替代方法。
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