新生儿重症监护病房收治的足月新生儿早发性败血症（2011-2016 年）。
Early-onset sepsis in term infants admitted to neonatal intensive care units (2011-2016).
机构信息
Duke Clinical Research Institute, Duke University, Durham, NC, USA.
Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark.
出版信息
J Perinatol. 2021 Jan;41(1):157-163. doi: 10.1038/s41372-020-00860-3. Epub 2020 Oct 17.
OBJECTIVES
Investigate characteristics of term infants culture-evaluated for early-onset sepsis (EOS) in neonatal intensive care units (NICUs), frequencies of organisms causing EOS, and factors associated with EOS.
STUDY DESIGN
Using a cohort design, we identified term infants evaluated for EOS with blood, cerebrospinal fluid, or urine cultures in 326 NICUs (2011-2016). Using multivariable logistic regression, we investigated the association between EOS and demographic characteristics.
RESULTS
Of 142,410 infants, 1197 (0.8%) had EOS, most commonly caused by group B Streptococcus (GBS; 40.6%). Lower EOS risk was associated with low Apgar score, Cesarean delivery, small for gestational age, prenatal antibiotic exposure, and positive or unknown maternal GBS screening result. Increased risk was associated with prolonged rupture of membranes, maternal age <19 years, vasopressor treatment, and ventilator support.
CONCLUSION(S): GBS was the most frequent cause of EOS. Early risk factor recognition may help daily management of term infants in NICUs.
目的
调查新生儿重症监护病房（NICU）中进行早期发病脓毒症（EOS）文化评估的足月婴儿的特征、引起 EOS 的病原体的频率以及与 EOS 相关的因素。
研究设计
我们采用队列设计，在 326 个 NICU 中（2011-2016 年），识别了 142410 名婴儿中接受血液、脑脊液或尿液培养以评估 EOS 的足月婴儿。使用多变量逻辑回归，我们研究了 EOS 与人口统计学特征之间的关联。
结果
在 142410 名婴儿中，有 1197 名（0.8%）患有 EOS，最常见的病原体是 B 组链球菌（GBS；40.6%）。较低的 EOS 风险与较低的 Apgar 评分、剖宫产、小于胎龄儿、产前抗生素暴露以及 GBS 筛查结果阳性或未知有关。风险增加与胎膜早破时间延长、母亲年龄<19 岁、血管加压素治疗和呼吸机支持有关。
结论
GBS 是 EOS 最常见的病因。早期危险因素的识别可能有助于 NICU 中足月婴儿的日常管理。
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