Choo K E, Wan Ariffin W A, Chua S P
Department of Paediatrics, University Sains Malaysia School of Medical Sciences.
Ann Acad Med Singap. 1988 Jul;17(3):438-42.
A retrospective study of 84 cases of neonatal septicaemia admitted into a neonatal unit in a rural area of Malaysia for 1 year between 1st September 1985 to 31st August 1986 was carried out to determine the spectrum of micro-organisms and predisposing factors in relation to early and late onset septicaemia. The incidence of neonatal septicaemia was 2.13 per 1,000 live-births per year and the case fatality was 41.7% with higher case fatality in those who were premature, those who presented as early onset and those who had gram negative septicaemia. The mean age of onset of septicaemia was 7.8 days (range from 2 hours to 27 days). Forty four (52%) neonates had early onset septicaemia with mean age of onset at 2.7 days; forty (48%) neonates had late onset septicaemia presenting at 13.6 days of life. Gram negative organisms such as Klebsiella, Pseudomonas, sp., E. coli and Streptococcus, especially group B Streptococcus were the major organisms in the early onset septicaemia. Staphylococcus aureus and Staphylococcus epidermidis were the major organisms responsible for the late onset septicaemia. Obstetrical factors played an important role in early onset septicaemia. Prematurity was the most common predisposing factor. Invasive diagnostic and therapeutic procedures including surgery highlighted once again the importance of these procedures in predisposing the newborn to infection.
对1985年9月1日至1986年8月31日期间马来西亚农村地区一家新生儿病房收治的84例新生儿败血症病例进行了回顾性研究，以确定与早发型和晚发型败血症相关的微生物谱和易感因素。新生儿败血症的发病率为每年每1000例活产中有2.13例，病死率为41.7%，早产儿、早发型患儿和革兰阴性菌败血症患儿的病死率更高。败血症的平均发病年龄为7.8天（范围从2小时至27天）。44例（52%）新生儿为早发型败血症，平均发病年龄为2.7天；40例（48%）新生儿为晚发型败血症，发病时间为出生后13.6天。革兰阴性菌如克雷伯菌属、假单胞菌属、大肠杆菌和链球菌，尤其是B族链球菌是早发型败血症的主要病原菌。金黄色葡萄球菌和表皮葡萄球菌是晚发型败血症的主要病原菌。产科因素在早发型败血症中起重要作用。早产是最常见的易感因素。包括手术在内的侵入性诊断和治疗操作再次凸显了这些操作在使新生儿易感染方面的重要性。
