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出生后6个月内抗生素的使用与严重细菌感染——来自丹麦东部的一项基于人群的队列研究

Use of Antibiotics and Severe Bacterial Infections Within the First 6 Months of Life-A Population-Based Cohort Study From East Denmark.

作者信息

Arnesen Anna Bjerager, Møller Nini, Vibede Louise Dyrberg, Vestergaard Kristian, Holm Sara Krøis, Trier Cæcilie, Stanchev Hristo, Dayani Gholamreza, Nygaard Ulrikka, Carlsen Emma Malchau, Hansen Bo Mølholm

机构信息

Department of Neonatology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.

Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Copenhagen University, Copenhagen, Denmark.

出版信息

Acta Paediatr. 2025 Sep;114(9):2261-2269. doi: 10.1111/apa.70103. Epub 2025 Apr 21.

Abstract

AIM

To investigate antibiotic exposure and the incidence of severe bacterial infections during the first 6 months of life in preterm infants born between 28 and 37 weeks of gestation.

METHODS

Retrospective population-based study of preterm infants in East Denmark, 2019-2021. Participants were identified based on dispensed antibiotics through the joint electronic health system. Infectious episodes were defined as suspected (≤ 4 days of treatment), probable (≥ 5 days of treatment) or proven if blood culture positive.

RESULTS

During the first 6 months of life, 557 of 5128 (11%) preterm infants received 635 courses. Two-thirds of all antibiotic courses were administered within the first 72 h of life, with 12 proven infections, that is, 2.3 per 1000 live births. Beyond 72 h of age, nearly all bacterial infection episodes were hospital acquired, with 24 proven infections, that is, 4.7 per 1000 live births. Three infants had sepsis-related mortality, that is, 0.58 per 1000 live births.

CONCLUSION

In preterm Danish infants aged 28-37 weeks of gestation, antibiotic treatment for suspected or probable infections was 15 times higher than for confirmed infections. Antibiotic exposure was high in this group of preterm infants, while confirmed infections were low.

摘要

目的

调查妊娠28至37周出生的早产儿出生后前6个月的抗生素暴露情况及严重细菌感染的发生率。

方法

对2019 - 2021年丹麦东部的早产儿进行基于人群的回顾性研究。通过联合电子健康系统根据分发的抗生素确定参与者。感染发作被定义为疑似(治疗≤4天)、可能(治疗≥5天)或血培养阳性则为确诊。

结果

在出生后的前6个月,5128名早产儿中有557名(11%)接受了635个疗程的治疗。所有抗生素疗程的三分之二在出生后的前72小时内使用,有12例确诊感染,即每1000例活产中有2.3例。在72小时之后,几乎所有细菌感染发作都是医院获得性的,有24例确诊感染,即每1000例活产中有4.7例。3名婴儿有败血症相关死亡,即每1000例活产中有0.58例。

结论

在丹麦妊娠28 - 37周的早产儿中,针对疑似或可能感染的抗生素治疗比确诊感染高15倍。这组早产儿的抗生素暴露率高,而确诊感染率低。

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