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爱尔兰新生儿菌血症:十年单机构回顾性研究。

Neonatal bacteraemia in Ireland: A ten-year single-institution retrospective review.

机构信息

Department of Microbiology, University Hospital Limerick, Limerick, Ireland.

School of Medicine and Centre for Interventions in Infection, Inflammation and Immunity (4i), University of Limerick, Limerick, Ireland.

出版信息

PLoS One. 2024 Aug 23;19(8):e0306855. doi: 10.1371/journal.pone.0306855. eCollection 2024.

Abstract

Neonatal sepsis is a catastrophic condition of global concern, with reported mortality rates exceeding 10%. Bloodstream infections are an important cause of sepsis, and epidemiological studies of these infections are crucial for predicting the most common aetiological agents and antimicrobial susceptibility patterns and for developing antimicrobial guidelines. For the ten-year study period from July 2013 to June 2023, all neonatal bacteraemia cases were reviewed prospectively using an enhanced surveillance protocol. The patients were stratified according to their age at the time of blood culture collection: early onset if diagnosed in the first 72 hours of life, and late onset if diagnosed after that time. During the study period, 170 blood cultures were positive from 144 patients, of which 89 specimens from 64 patients represented the growth of significant pathogens. Coagulase-negative staphylococci (CoNS) were the most common pathogens identified (52%, 33/64), followed by Escherichia coli (14%, 9/64), Group B Streptococcus (GBS: 11%, 7/64) and Staphylococcus aureus (11%, 7/64). GBS was more commonly identified in early onset patients, while CoNS were predominantly associated with late onset. The presence of an intravascular catheter, maternal urinary tract infections and the receipt of total parenteral nutrition or transfused blood were identified as significant risk factors. The fatality rate was 8% (5/64). in summary, this study provides a detailed overview of the epidemiology of neonatal bacteraemia in a large teaching hospital in the Midwest of Ireland over a decade.

摘要

新生儿败血症是一种具有全球灾难性的疾病,其死亡率超过 10%。血流感染是败血症的一个重要原因,对这些感染进行流行病学研究对于预测最常见的病因和抗菌药物敏感性模式以及制定抗菌药物指南至关重要。在 2013 年 7 月至 2023 年 6 月的十年研究期间,所有新生儿菌血症病例均使用增强监测方案进行前瞻性审查。根据血培养采集时的年龄将患者分层:如果在生命的前 72 小时内诊断为早发性败血症,如果在此之后诊断则为晚发性败血症。在研究期间,从 144 名患者中采集的 170 份血培养结果为阳性,其中 89 份来自 64 名患者的标本代表了有意义的病原体的生长。凝固酶阴性葡萄球菌(CoNS)是最常见的病原体(52%,33/64),其次是大肠杆菌(14%,9/64)、B 组链球菌(GBS:11%,7/64)和金黄色葡萄球菌(11%,7/64)。GBS 在早发性败血症患者中更为常见,而 CoNS 主要与晚发性败血症有关。血管内导管的存在、母亲尿路感染以及接受全胃肠外营养或输血被确定为显著的危险因素。死亡率为 8%(5/64)。总之,本研究提供了在爱尔兰中西部的一家大型教学医院中十年来新生儿菌血症的流行病学详细概述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6b2/11343407/ef549cc5704a/pone.0306855.g001.jpg

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