Tulzer G, Hohenauer L
Neugeborenen- und Säuglingsabteilung, Landeskinder-krankenhauses Linz.
Wien Med Wochenschr. 1988 May 15;138(9):213-6.
Among 1252 consecutively treated intensive-neonatologic patients during the years 1985 to 1987 79 cases (= 6.5%) of neonatal septicemia were diagnosed by positive blood- and/or cerebrospinal fluid cultures. The relation between early onset type (up to the 4th day of life) and late onset type was 4:1. The most frequent pathogen was Staphylococcus epidermidis (40% of early onset type, 56% of late onset type) followed in the case of early onset type by Listeria monocytogenes (13%), Streptococci (11%), E. coli (11%) and Staphylococcus aureus (10%). Susceptibility to antibiotics is described. Primary therapy of early onset type septicemia must be effective against Listeria monocytogenes and Streptococci. We recommend a combination of a beta-lactam- and an aminoglycosid antibiotic. In case of late onset type we used a cephalosporin in combination with netilmycin. The importance of good hospital hygiene, frequent blood cultures and correct application of aminoglycosid antibiotics is pointed out.
在1985年至1987年期间连续治疗的1252例新生儿重症患者中，79例（占6.5%）新生儿败血症通过血培养和/或脑脊液培养阳性得以确诊。早发型（出生后4天内）与晚发型的比例为4:1。最常见的病原体是表皮葡萄球菌（早发型占40%，晚发型占56%），早发型其次是单核细胞增生李斯特菌（13%）、链球菌（11%）、大肠杆菌（11%）和金黄色葡萄球菌（10%）。文中描述了对抗生素的敏感性。早发型败血症的初始治疗必须对单核细胞增生李斯特菌和链球菌有效。我们建议联合使用β-内酰胺类抗生素和氨基糖苷类抗生素。对于晚发型病例，我们使用头孢菌素联合奈替米星。文中指出了良好的医院卫生、频繁的血培养以及氨基糖苷类抗生素的正确使用的重要性。
