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土耳其一家三级医院新生儿重症监护病房新生儿败血症病例的细菌学特征及抗生素敏感性

Bacteriological Profile and Antibiotic Susceptibility of Neonatal Sepsis Cases in the Neonatal Intensive Care Unit of a Tertiary Hospital in Türkiye.

作者信息

Dorum Bayram Ali, Elmas Bozdemir Şefika, Kral Bensu Zadeoğlu, Erdoğan Ayten, Çakır Salih Çağrı

机构信息

Division of Neonatology, Department of Pediatrics, Bursa City Hospital, Bursa 16110, Türkiye.

Division of Pediatric Infection, Department of Pediatrics, Bursa City Hospital, Bursa 16110, Türkiye.

出版信息

Children (Basel). 2024 Sep 30;11(10):1208. doi: 10.3390/children11101208.

Abstract

OBJECTIVE

We aimed to determine the demographic data, mortality, and morbidity of early- and late-neonatal sepsis cases, the etiologic agents in these cases, and the antibiotic susceptibility of these agents.

METHODS

This study was conducted retrospectively in a tertiary neonatal intensive care unit (NICU). The demographic, clinical, and laboratory data of newborns diagnosed with culture-proven sepsis within 24 months were evaluated.

RESULTS

Two hundred and eleven culture data points belonging to 197 infants were evaluated. Forty percent of the infants had a history of premature birth. The most common clinical findings were respiratory distress and feeding intolerance. (CoNS) were detected most frequently as early- and late-sepsis agents. The most common Gram-negative bacteria detected as late-sepsis agents were spp. and (). The overall mortality rate was 10%.

CONCLUSIONS

Neonatal sepsis continues to have high mortality rates in tertiary NICUs. CoNS was the most common agent, highlighting the importance of developing and maintaining personnel training and handwashing practices. It will be important to consider the resistance rates of spp., the most common Gram-negative agent in late-onset sepsis (LOS) cases, to commonly used antibiotics in empirical treatments.

摘要

目的

我们旨在确定早发型和晚发型新生儿败血症病例的人口统计学数据、死亡率和发病率、这些病例中的病原体以及这些病原体的抗生素敏感性。

方法

本研究在一家三级新生儿重症监护病房(NICU)进行回顾性研究。对在24个月内诊断为血培养证实的败血症的新生儿的人口统计学、临床和实验室数据进行评估。

结果

对197名婴儿的211份血培养数据点进行了评估。40%的婴儿有早产史。最常见的临床发现是呼吸窘迫和喂养不耐受。凝固酶阴性葡萄球菌(CoNS)作为早发型和晚发型败血症病原体被检测到的频率最高。作为晚发型败血症病原体检测到的最常见革兰氏阴性菌是大肠埃希菌属和肺炎克雷伯菌(肺炎亚种)。总体死亡率为10%。

结论

在三级NICU中,新生儿败血症的死亡率仍然很高。CoNS是最常见的病原体,凸显了开展和维持人员培训及洗手措施的重要性。在经验性治疗中,考虑晚发性败血症(LOS)病例中最常见的革兰氏阴性病原体大肠埃希菌属对常用抗生素的耐药率将很重要。

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Turkish Neonatal Society guideline on neonatal infections-diagnosis and treatment.土耳其新生儿学会关于新生儿感染的诊断与治疗指南。
Turk Pediatri Ars. 2018 Dec 25;53(Suppl 1):S88-S100. doi: 10.5152/TurkPediatriArs.2018.01809. eCollection 2018.
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Epidemiology of infections and antimicrobial use in Greek Neonatal Units.希腊新生儿单位感染和抗菌药物使用的流行病学。
Arch Dis Child Fetal Neonatal Ed. 2019 May;104(3):F293-F297. doi: 10.1136/archdischild-2018-315024. Epub 2018 Jun 28.
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Late-onset neonatal sepsis: recent developments.迟发性新生儿败血症:最新进展
Arch Dis Child Fetal Neonatal Ed. 2015 May;100(3):F257-63. doi: 10.1136/archdischild-2014-306213. Epub 2014 Nov 25.
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"Less is more": decreasing antibiotic days in the NICU.“少即是多”:减少新生儿重症监护病房的抗生素使用天数
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