Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Case Cardiovascular Research Institute, Cleveland, OH, USA.
J Perinatol. 2024 Dec;44(12):1816-1821. doi: 10.1038/s41372-024-02117-9. Epub 2024 Sep 12.
Neonatal Escherichia coli (E. coli) sepsis is increasing. There is limited data on the factors contributing to increased mortality and severity of illness in neonatal E. coli sepsis. A retrospective review of neonates (<30 days) admitted to a Level IV NICU in the United States from 2008 to 2022 diagnosed with E. coli bloodstream or cerebrospinal fluid infection was conducted. Primary outcome was defined as mortality from or severe illness during E. coli infection (defined as a need for inotropic support or metabolic acidosis). E. coli neonatal sepsis rate increased from 2008 to 2022 (average of 1.12 per 1000 live births). The primary outcome, which occurred in 57.4% of cases, was independently associated with prematurity, neutropenia, and thrombocytopenia. Ampicillin resistance was not associated with the primary outcome. GA, neutropenia, and thrombocytopenia but not ampicillin resistance, are associated with mortality or severe illness from E. coli sepsis.
新生儿大肠杆菌（E. coli）败血症的发病率正在上升。关于导致新生儿大肠杆菌败血症死亡率和疾病严重程度增加的因素的数据有限。对 2008 年至 2022 年期间在美国一家四级 NICU 住院的诊断为大肠杆菌血流或脑脊液感染的新生儿（<30 天）进行了回顾性研究。主要结局定义为大肠杆菌感染期间的死亡率或严重疾病（定义为需要正性肌力支持或代谢性酸中毒）。大肠杆菌新生儿败血症的发病率从 2008 年到 2022 年有所上升（平均每 1000 例活产中有 1.12 例）。主要结局（占 57.4%的病例）与早产儿、中性粒细胞减少症和血小板减少症独立相关。氨苄西林耐药性与主要结局无关。GA、中性粒细胞减少症和血小板减少症，但不是氨苄西林耐药性，与大肠杆菌败血症的死亡率或严重疾病有关。
