Lu Lianghua, Li Pei, Pan Tao, Feng Xing
Department of Neonatology, Children's Hospital of Soochow University.
Jpn J Infect Dis. 2020 Mar 24;73(2):148-152. doi: 10.7883/yoken.JJID.2019.243. Epub 2019 Nov 29.
Early-onset sepsis (EOS) in neonates is a serious disease with severe complications. The increased severity of EOS and risk of death in newborns in recent years signify that continued monitoring to detect possible changes in the pathogen etiology, disease severity, and disease outcome is particularly important. We conducted a retrospective study on early-onset infection among infants (birth weights > 800 g) who were hospitalized in the Children's Hospital of Soochow University from January 1, 2011, to December 31, 2017. Multivariable analysis was performed to determine the significant predictors of mortality. The most frequent early-onset pathogen was Group B Streptococcus (GBS) (28.1%), followed by Escherichia coli (21.6%), Listeria monocytogenes (11.8%), and Klebsiella pneumoniae (7.8%). Most infants (85.6%) with early-onset infections survived until hospital discharge, while 44 (14.4%) patients died. Multivariable logistic regression analysis showed that the significant predictors of mortality were the pathogen (GBS, E. coli, or other pathogens) and birth weight (both P < 0.01). GBS remains the most frequent pathogen known to infect infants. E coli was the most common pathogen associated with neonatal mortality. Prevention of E. coli sepsis, specifically among preterm infants, remains a challenge.
新生儿早发型败血症(EOS)是一种伴有严重并发症的严重疾病。近年来,新生儿EOS严重程度增加及死亡风险上升,这表明持续监测以发现病原体病因、疾病严重程度和疾病转归的可能变化尤为重要。我们对2011年1月1日至2017年12月31日在苏州大学附属儿童医院住院的婴儿(出生体重>800g)早发型感染进行了一项回顾性研究。进行多变量分析以确定死亡率的显著预测因素。最常见的早发型病原体是B族链球菌(GBS)(28.1%),其次是大肠杆菌(21.6%)、单核细胞增生李斯特菌(11.8%)和肺炎克雷伯菌(7.8%)。大多数早发型感染婴儿(85.6%)存活至出院,而44例(14.4%)患者死亡。多变量逻辑回归分析表明,死亡率的显著预测因素是病原体(GBS、大肠杆菌或其他病原体)和出生体重(P均<0.01)。GBS仍然是已知感染婴儿的最常见病原体。大肠杆菌是与新生儿死亡相关的最常见病原体。预防大肠杆菌败血症,特别是在早产儿中,仍然是一项挑战。