Leibovitz E, Flidel-Rimon O, Juster-Reicher A, Amitay M, Miskin A, Barak Y, Mogilner B
Department of Neonatology, Kaplan Hospital, Rehovot, Israel.
Isr J Med Sci. 1997 Nov;33(11):734-8.
During the 4-year period 1989-1992, 18,227 neonates were born at Kaplan Hospital and 614 (3.4%) were admitted to the neonatal intensive care unit. During this period, 120 episodes (6.6/1000 live births) of neonatal sepsis were recorded in 109 neonates (6/1000 live births). The incidence of early-onset sepsis was 19/109 (17%). The main pathogens of early-onset sepsis were S. agalactiae (42%) and E. coli (32%). Seven of the 8 S. agalactiae cases were recorded during 1989-1990. The main pathogens of late-onset sepsis were Klebsiella spp. (31%), coagulase-negative staphylococci (18%) and Candida spp (16%). There were 11 cases (10%) of meningitis, 5 due to Klebsiella spp. The overall fatality rate due to sepsis was 14% (0.8/1000 live births) with an early-onset sepsis death rate of 37%. The mortality from S. agalactiae sepsis was 63%. The main trends recorded during the period of the study were 1) the emergence of S. agalactiae as the main pathogen of early-onset sepsis, followed by a sharp decrease in its incidence during the last part of the study, 2) the emergence of extremely virulent, multi-antibiotic-resistant Klebsiella organisms, and 3) the persistent high incidence of Candida sepsis.
在1989年至1992年的4年期间，卡普兰医院共出生18227名新生儿，其中614名（3.4%）被收治入新生儿重症监护病房。在此期间，109名新生儿（每1000例活产中有6例）记录了120例新生儿败血症发作（每1000例活产中有6.6例）。早发型败血症的发病率为19/109（17%）。早发型败血症的主要病原体是无乳链球菌（42%）和大肠杆菌（32%）。8例无乳链球菌病例中有7例记录于1989年至1990年期间。晚发型败血症的主要病原体是克雷伯菌属（31%）、凝固酶阴性葡萄球菌（18%）和念珠菌属（16%）。有11例（10%）脑膜炎病例，其中5例由克雷伯菌属引起。败血症的总体死亡率为14%（每1000例活产中有0.8例），早发型败血症死亡率为37%。无乳链球菌败血症的死亡率为63%。研究期间记录的主要趋势为：1）无乳链球菌成为早发型败血症的主要病原体，随后在研究后期其发病率急剧下降；2）出现了毒性极强、多重耐药的克雷伯菌属微生物；3）念珠菌败血症的发病率持续居高不下。
