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新生儿金黄色葡萄球菌败血症:西澳大利亚 20 年经验。

Neonatal Staphylococcus Aureus Sepsis: a 20-year Western Australian experience.

机构信息

Medical School, University of Western Australia, Perth, WA, Australia.

Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, WA, Australia.

出版信息

J Perinatol. 2022 Nov;42(11):1440-1445. doi: 10.1038/s41372-022-01440-3. Epub 2022 Jun 25.

Abstract

OBJECTIVES

The purpose of this study was to characterise neonatal Staphylococcus aureus (SA) sepsis in Western Australia (WA) between 2001 and 2020 at the sole tertiary neonatal intensive care unit (NICU), examine risk factors for sepsis in the cohort, and compare short- and long-term outcomes to control infants without any sepsis.

METHODS

Retrospective cohort study at the Neonatal Directorate at King Edward Memorial Hospital (KEMH) and Perth Children's Hospital, using electronic databases and patient medical records.

RESULTS

The overall incidence of SA sepsis was 0.10 per 1000 live births (62/614207). From 2001 to 2010 the incidence was 0.13/1000 live births, reducing to 0.07/1000 live births from 2011 to 2020. SA was most frequently isolated from endotracheal aspirates, and infants with SA sepsis had longer median duration of ventilatory support than those without any sepsis (31 days vs 18 days respectively, p < 0.001). In our cohort, SA sepsis was associated with worse neurodevelopmental outcomes compared to infants without any sepsis.

CONCLUSIONS

The incidence of neonatal SA sepsis has reduced over the last 20 years, suggesting potential effectiveness of the preventative interventions implemented. Endotracheal tube (ETT) colonisation and prolonged ventilation may be under-recognised as potential sources of SA infection. Our study suggests SA sepsis may negatively impact neurodevelopmental outcomes.

摘要

目的

本研究旨在描述 2001 年至 2020 年期间西澳大利亚州(WA)一家三级新生儿重症监护病房(NICU)中新生儿金黄色葡萄球菌(SA)败血症的特征,分析该队列中败血症的危险因素,并将其与无任何败血症的对照婴儿的短期和长期结局进行比较。

方法

这是一项在 KEMH 和 Perth 儿童医院新生儿科进行的回顾性队列研究,使用电子数据库和患者病历。

结果

SA 败血症的总发生率为每 1000 例活产儿 0.10 例(62/614207)。2001 年至 2010 年的发生率为 0.13/1000 活产儿,2011 年至 2020 年降至 0.07/1000 活产儿。SA 最常从气管内吸出物中分离出来,且患有 SA 败血症的婴儿通气支持时间中位数长于无任何败血症的婴儿(分别为 31 天和 18 天,p<0.001)。在本队列中,SA 败血症与无任何败血症的婴儿相比,神经发育结局更差。

结论

过去 20 年中,新生儿 SA 败血症的发病率有所下降,表明实施的预防干预措施可能具有一定效果。气管内管(ETT)定植和延长通气可能被低估为 SA 感染的潜在来源。我们的研究表明,SA 败血症可能对神经发育结局产生负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05b9/9616716/3d9cf042da42/41372_2022_1440_Fig1_HTML.jpg

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