Crosson F J, Feder H M, Bocchini J A, Hackell J M, Hackell J G
Johns Hopkins Med J. 1977 Feb;140(2):37-46.
The experience with neonatal sepsis at The Johns Hopkins Hospital during 1969-1975 was reviewed. Major pathogens included Escherichia coli, group B streptococcus, other streptococci, and Klebsiella. Nineteen percent of coliform isolates were kanamycin-resistant. The frequency of recovery of E. coli was increased in early-onset sepsis, and the frequency of recovery of Klebsiella was increased in late-onset sepsis. The mortality rate was 23%. The frequency of recovery of E. coli was increased in fatal cases, and mortality was highly correlated with the presence of gastrointestinal catastrophe. Ampicillin and gentamicin are the initial antibiotics of choice for neonatal sepsis at this institution; a penicillinase-resistant penicillin should be added when Staphylococcus aureus involvement is likely, and addition of chloramphenicol or clindamycin should be considered for infants at increased risk for Bacteroides fragilis sepsis.
回顾了1969年至1975年约翰霍普金斯医院新生儿败血症的情况。主要病原体包括大肠杆菌、B组链球菌、其他链球菌和克雷伯菌。19%的大肠菌群分离株对卡那霉素耐药。早发型败血症中大肠杆菌的分离频率增加，晚发型败血症中克雷伯菌的分离频率增加。死亡率为23%。致命病例中大肠杆菌的分离频率增加，死亡率与胃肠道灾难的存在高度相关。氨苄西林和庆大霉素是该机构新生儿败血症的初始首选抗生素；当可能有金黄色葡萄球菌感染时，应添加耐青霉素酶的青霉素，对于有脆弱拟杆菌败血症风险增加的婴儿，应考虑添加氯霉素或克林霉素。
