Rathore Heeranand, Rahman Arshalooz J, Salman Muhammad, Nasir Muhammad, Sherali Seharish
Paediatrics and Child Health, The Aga Khan University, Karachi, PAK.
Paediatrics and Child Health, The Aga Khan Univeristy, Karachi, PAK.
Cureus. 2020 Feb 4;12(2):e6864. doi: 10.7759/cureus.6864.
Introduction In developing countries, sepsis and associated mortality rates in neonatal patients is a serious concern. To improve the outcomes and mortality posed by sepsis, physicians need to know the local epidemiology of the microbial pathogens and their resistance patterns to antimicrobial agents. Therefore, our aim was to determine the frequency of early-onset neonatal sepsis (EONS) following prolonged rupture of membranes (PROM). Materials and methods After approval from the ethical review committee, this cross-sectional study was conducted at a tertiary care hospital of a developing country, and informed consent was taken from patients' parents. All neonates born to a mother with PROM after 24 weeks of gestation up to seven days of life were included. Demographic features, signs of sepsis, blood culture results, and laboratory markers of sepsis were recorded. All data were analyzed by using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY). Results A total of 124 patients were enrolled in the study. Seven neonates (5.6%) developed EONS and positive cultures were seen in four neonates (3.2%) with a maternal history of PROM. The organisms identified in cultures were Klebsiella pneumonia, group B streptococcus, Staphylococcus aureus, and Streptococcus species in EONS caused by prolonged PROM. Conclusions Early recognition of risk factors, recognition of clinical conditions with prompt laboratory screening for infection, and early establishment of empirical antibiotic treatment are effective preventive measures. Such approaches would be a secure and efficient strategy, particularly in developing countries.
引言 在发展中国家,新生儿脓毒症及其相关死亡率是一个严重问题。为改善脓毒症导致的后果和死亡率,医生需要了解微生物病原体的当地流行病学情况及其对抗菌药物的耐药模式。因此,我们的目的是确定胎膜早破(PROM)后早发型新生儿脓毒症(EONS)的发生率。
材料与方法 经伦理审查委员会批准后,在一个发展中国家的三级护理医院开展了这项横断面研究,并获得了患者父母的知情同意。纳入所有在妊娠24周后胎膜早破的母亲所生且出生后7天内的新生儿。记录人口统计学特征、脓毒症体征、血培养结果和脓毒症的实验室指标。所有数据均使用IBM SPSS Statistics for Windows 20.0版(IBM公司,纽约州阿蒙克)进行分析。
结果 共有124名患者纳入研究。7名新生儿(5.6%)发生了早发型新生儿脓毒症,4名有胎膜早破母亲病史的新生儿(占3.2%)血培养呈阳性。胎膜早破导致的早发型新生儿脓毒症血培养中鉴定出的病原体为肺炎克雷伯菌、B组链球菌、金黄色葡萄球菌和链球菌属。
结论 早期识别危险因素、通过及时的实验室感染筛查识别临床情况以及早期建立经验性抗生素治疗是有效的预防措施。这些方法将是一种安全有效的策略,尤其在发展中国家。