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中国苏州的晚发型新生儿败血症。

Late-onset neonatal sepsis in Suzhou, China.

作者信息

Pan Tao, Zhu Qiujiao, Li Pei, Hua Jun, Feng Xing

机构信息

Department of Neonatology, Children's Hospital of Soochow University, Soochow University, Suzhou, China.

Department of Internal Medicine, Children's Hospital of Wujiang District, Suzhou, China.

出版信息

BMC Pediatr. 2020 May 29;20(1):261. doi: 10.1186/s12887-020-02103-y.

Abstract

BACKGROUND

This study aimed to describe the causative organisms of neonatal late-onset sepsis (LOS) and their antimicrobial resistance in Suzhou, Southeast China over a 7-year period.

METHODS

We performed a retrospective study on neonates with LOS from Jan1, 2011 to Dec 31, 2017. The demographic, clinical, and laboratory data of neonates with LOS were analyzed. Logistic regression was used to investigate the risk factors with mortality.

RESULTS

During the study period, 202 neonates with LOS were finally identified. The most common pathogens were Escherichia coli (29.2%), followed by Klebsiella pneumoniae (19.3%), and Coagulase-negative Staphylococcus (CoNS) (16.8%). Nearly 90% of the K. pneumoniae were resistant to cefazolin and 71.8% to ceftazidime. Thirty-four patients (16.8%) died. Multivariable logistic regression showed that significant predictors of mortality were birth weight < 1500 g, respiratory distress and convulsions.

CONCLUSIONS

Gram-negative organisms have an important role in LOS in our region, with high levels of resistance to third-generation cephalosporins. These data may help in the selection of antibiotics for empirical treatment of neonates with sepsis.

摘要

背景

本研究旨在描述中国东南部苏州地区7年间新生儿晚发性败血症(LOS)的致病微生物及其耐药性。

方法

我们对2011年1月1日至2017年12月31日期间患有LOS的新生儿进行了一项回顾性研究。分析了LOS新生儿的人口统计学、临床和实验室数据。采用逻辑回归分析调查死亡的危险因素。

结果

在研究期间,最终确定了202例患有LOS的新生儿。最常见的病原体是大肠杆菌(29.2%),其次是肺炎克雷伯菌(19.3%)和凝固酶阴性葡萄球菌(CoNS)(16.8%)。近90%的肺炎克雷伯菌对头孢唑林耐药,71.8%对头孢他啶耐药。34例患者(16.8%)死亡。多变量逻辑回归显示,死亡的显著预测因素是出生体重<1500g、呼吸窘迫和惊厥。

结论

革兰氏阴性菌在我们地区的LOS中起重要作用,对第三代头孢菌素耐药性高。这些数据可能有助于选择抗生素对败血症新生儿进行经验性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a47/7257513/2ac6c6169851/12887_2020_2103_Fig1_HTML.jpg

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