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2011 年 6 月至 2017 年 6 月广州市新生儿败血症的临床特征及病原菌谱

Clinical Characteristic and Pathogen Spectrum of Neonatal Sepsis in Guangzhou City from June 2011 to June 2017.

机构信息

Clinical Department, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China (mainland).

出版信息

Med Sci Monit. 2019 Mar 29;25:2296-2304. doi: 10.12659/MSM.912375.

DOI:10.12659/MSM.912375
PMID:30924465
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6451358/
Abstract

BACKGROUND Preterm and low birth weight (birth weight <2500 g) neonates are vulnerable to sepsis, and the causative pathogens vary in different regions and times. The objective of this study was to identify common organisms leading to neonatal sepsis and identify the characteristic of patients infected with different bacteria, which may help in the selection of antibiotics for empirical treatment. MATERIAL AND METHODS We retrospectively collected the clinical and microbiological data of neonates with culture-proven sepsis in our clinical setting from June 2011 to June 2017. The demography, composition, and distribution of the pathogens and the clinical characteristic of the cases infected with different bacteria were analyzed. RESULTS Of a total of 1048 bacteria that were isolated from patient samples, detailed clinical and microbiological data of 297 cases were available. Escherichia coli, Klebsiella pneumoniae, and coagulase-negative Staphylococcus (co-NS) were the top 3 isolated pathogens. Streptococcus agalactiae predominantly led to early-onset sepsis, while K. pneumoniae and Staphylococcus aureus mainly led to late-onset sepsis. K. pneumoniae was mainly acquired in the hospital. Leukopenia was more commonly seen than leukocytosis in our study, and patients infected with K. pneumoniae and Candida spp encountered more thrombocytopenia. CONCLUSIONS The results of our study revealed the composition of the pathogens of neonatal sepsis in our region and the clinical characteristic of sepsis caused by different bacteria; these data may help in the selection of antibiotics for empirical treatment of neonates with high risk of sepsis.

摘要

背景

早产儿和低出生体重儿(出生体重<2500g)易患败血症,且不同地区和时间的致病病原体不同。本研究旨在确定导致新生儿败血症的常见病原体,并确定感染不同细菌的患者的特征,这有助于经验性治疗选择抗生素。

材料与方法

我们回顾性收集了 2011 年 6 月至 2017 年 6 月我院确诊为败血症的新生儿的临床和微生物学数据。分析了病原体的构成、分布以及感染不同细菌患者的临床特征。

结果

从患者样本中分离出的 1048 株细菌中,有 297 例的详细临床和微生物学数据可用。大肠埃希菌、肺炎克雷伯菌和凝固酶阴性葡萄球菌(co-NS)是前 3 位分离病原体。无乳链球菌主要引起早发型败血症,而肺炎克雷伯菌和金黄色葡萄球菌主要引起晚发型败血症。肺炎克雷伯菌主要在医院获得。与白细胞增多相比,本研究中白细胞减少更为常见,感染肺炎克雷伯菌和念珠菌的患者更易发生血小板减少症。

结论

本研究结果揭示了本地区新生儿败血症病原体的构成以及不同细菌引起败血症的临床特征;这些数据可能有助于经验性治疗高风险败血症新生儿选择抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6277/6451358/a9d5955e0ffd/medscimonit-25-2296-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6277/6451358/a9d5955e0ffd/medscimonit-25-2296-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6277/6451358/a9d5955e0ffd/medscimonit-25-2296-g001.jpg

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