Li Jinchun, Xia Shiwen, Liu Yong, Zhang Shasha, Jin Zhengjiang
Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China.
Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China.
Infect Drug Resist. 2022 Feb 11;15:427-438. doi: 10.2147/IDR.S341536. eCollection 2022.
To evaluate the microorganisms involved in neonatal septicemia and its antibiotic susceptibility pattern and to further investigate the factors associated with the length of intensive care unit (ICU) stay in neonatal septicemia.
A total of 297 infants with septicemia at neonatal ICU (NICU), Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2020 were enrolled. Identification of bacterial species was done using the standard positive blood culture. Data included demographics, signs at time of septicemia, laboratory values, patient sources, complications, microbiologic characteristics, and the duration of ICU stay. Univariate and multivariate gamma regression analyses were applied to determine the variables associated with ICU stay.
The result demonstrated that the main causative pathogens of neonatal septicemia in our hospital were Gram-positive bacteria, among which (100 isolates, 47.17%) was the main conditional pathogens; (27 isolates, 49.09%) was most frequently isolated among Gram-negative pathogens. Gram-positive bacteria had higher susceptibility to vancomycin, tigecycline and linezolid. was susceptive to piperacillin (27/27, 100.00%), cefotetan (27/27, 100.00%), meropenem and imipenem (27/27, 100.00%). (95% CI: 0.140-0.539), for patients who were transferred from other hospital (95% CI: 0.016 to 0.354), septicemia during hospitalization (95% CI: 0.411 to 0.825), the use of antibacterial drug during pregnancy (95% CI: 0.362 to 2.136), feeding intolerance (95% CI: 0.127 to 0.437), bradycardia (95% CI: 0.196 to 0.838), septicemia newborns have complications (95% CI: 0.063 to 0.291), the onset age (95% CI: 0.006 to 0.023), TRIPS score (95% CI: 0.005 to 0.016), and CRP level (95% CI: 0.002 to 0.005) were related to prolonged ICU stay days.
This study summarized common pathogens and associated drug sensitivity, and factors influencing ICU stay length. Prevention and control policy in the NICU should be strengthened.
评估新生儿败血症相关微生物及其抗生素敏感性模式,并进一步研究与新生儿败血症重症监护病房(ICU)住院时间相关的因素。
纳入2016年至2020年在华中科技大学同济医学院附属湖北省妇幼保健院新生儿重症监护病房(NICU)的297例败血症婴儿。使用标准阳性血培养进行细菌种类鉴定。数据包括人口统计学、败血症时的体征、实验室值、患者来源、并发症、微生物学特征以及ICU住院时间。应用单因素和多因素伽马回归分析来确定与ICU住院时间相关的变量。
结果表明,我院新生儿败血症的主要致病病原体为革兰氏阳性菌,其中(100株,47.17%)是主要的条件致病菌;(27株,49.09%)是革兰氏阴性病原体中最常分离出的菌。革兰氏阳性菌对万古霉素、替加环素和利奈唑胺敏感性较高。对哌拉西林(27/27,100.00%)、头孢替坦(27/27,100.00%)、美罗培南和亚胺培南(27/27,100.00%)敏感。(95%可信区间:0.140 - 0.539),对于从其他医院转入的患者(95%可信区间:0.016至0.354)、住院期间发生败血症(95%可信区间:0.411至0.825)、孕期使用抗菌药物(95%可信区间:0.362至2.136)、喂养不耐受(95%可信区间:0.127至0.437)、心动过缓(95%可信区间:0.196至0.838)、败血症新生儿有并发症(95%可信区间:0.063至0.291)、发病年龄(95%可信区间:0.006至0.023)、TRIPS评分(95%可信区间:0.005至0.016)以及CRP水平(95%可信区间:0.002至0.005)与ICU住院天数延长有关。
本研究总结了常见病原体及相关药敏情况,以及影响ICU住院时间的因素。应加强NICU的防控策略。