Nathoo K J, Mason P R, Gwanzura L, Kowo H, Mubaiwa L
Department of Paediatrics and Child Health, University of Zimbabwe Medical School, Harare.
Pediatr Infect Dis J. 1993 Oct;12(10):840-4. doi: 10.1097/00006454-199310000-00009.
Postmortem blood cultures were taken from 105 neonates dying at Harare Hospital during a 1-year period. The infants were characterized by prematurity (63% < 37 weeks gestation), low birth weight (60% < 2500 g) and low Apgar score at 1 min (43% < 3). More than one-half of the infants died within 48 hours of admission. Positive blood cultures within 10 minutes of death occurred in 44% of infants, and Klebsiella sp. were by far the most common isolates. Positive blood cultures were associated with very low birth weight (< 1500 g), and with babies who survived for > 48 hours. Antibodies to human immunodeficiency virus type 1 were found in 40% of the infants, and a high proportion of these had Klebsiella bacteremia. Nearly all the infants had received antibiotic therapy, usually penicillin and gentamicin. Very few babies who had received a cephalosporin had a positive blood culture, and in vitro tests showed that although many organisms were resistant to penicillin and the aminoglycosides, very few showed resistance to the cephalosporins. Our findings suggest that cephalosporins may be useful in treating severe neonatal sepsis, particularly when there is no response to more standard therapy.
在一年期间，从哈拉雷医院死亡的105名新生儿身上采集了死后血培养样本。这些婴儿的特点是早产（63%胎龄<37周）、低出生体重（60%<2500克）以及1分钟时阿氏评分低（43%<3分）。超过一半的婴儿在入院后48小时内死亡。44%的婴儿在死亡后10分钟内血培养呈阳性，其中肺炎克雷伯菌属是迄今为止最常见的分离菌。血培养阳性与极低出生体重（<1500克）以及存活超过48小时的婴儿有关。在40%的婴儿中发现了1型人类免疫缺陷病毒抗体，其中很大一部分患有肺炎克雷伯菌血症。几乎所有婴儿都接受了抗生素治疗，通常是青霉素和庆大霉素。很少有接受头孢菌素治疗的婴儿血培养呈阳性，体外试验表明，虽然许多微生物对青霉素和氨基糖苷类耐药，但很少对头孢菌素耐药。我们的研究结果表明，头孢菌素可能有助于治疗严重的新生儿败血症，尤其是在对更标准的治疗无反应时。
