论文部分内容阅读
目的总结分析某院新生儿败血症早发型(Early-OnsetSepsis,EOS)与晚发型(Late-OnsetSepsis,LOS)的临床特点、致病菌分布及耐药情况,为早期诊断提供依据。方法选择某院2009年1月至2012年12月收治的209例新生儿败血症的临床资料,其中早发型66例,晚发型143例,进行统计分析。结果新生儿败血症早发组与围生因素密切相关;晚发组呼吸道、脐部、皮肤感染高于早发组;早发组血小板(PLT)降低较晚发组多见;血培养阳性58例,病原菌检出率27.7%,晚发组检出率高于早发组;早发组大肠埃希菌感染较晚发组多见。检出的革兰阳性菌对青霉素、克林霉素、红霉素耐药率在90%以上,对左氧氟沙星、庆大霉素耐药率在50%左右,对万古霉素、替考拉宁、利奈唑胺耐药率为0%。检出的革兰阴性菌对阿米卡星、亚胺培南、美罗培南耐药率为0%,对头孢唑林、头孢曲松、头孢他啶耐药率不足40%,对头孢噻吩、头孢噻肟、头孢呋辛耐药率在80%以上。结论新生儿败血症早发型与晚发型临床特点各不相同,早期诊断需结合围生情况、局部感染灶、实验室检查,并根据本地区致病菌分布特点,合理选择抗生素。
Objective To summarize and analyze the clinical features, pathogens distribution and drug resistance of early-on-set sepsis (EOS) and late-onset sepsis (LOS) in a hospital and provide a basis for early diagnosis. Methods The clinical data of 209 cases of neonatal sepsis admitted in a hospital from January 2009 to December 2012 were retrospectively analyzed. Among them, 66 were early-onset and 143 were late-onset, and were analyzed statistically. Results Early neonatal sepsis was closely related to peripheral factors. The late-onset respiratory tract, umbilicus and skin infections were higher in early-onset group than in early-onset group. Platelet (PLT) was lower in early-onset group than in late-onset group. , The detection rate of pathogenic bacteria was 27.7%, detection rate of late onset group was higher than that of early onset group. Escherichia coli infection in early onset group was more common than late onset group. Gram-positive bacteria detected penicillin, clindamycin, erythromycin resistance rate of 90%, levofloxacin, gentamicin resistance rate of about 50%, vancomycin, teicoplanin , Linezolid resistance rate was 0%. Gram negative bacteria detected amikacin, imipenem, meropenem resistance rate was 0%, cefazolin, ceftriaxone, ceftazidime resistance rate of less than 40% of cephalothin, cefotaxime Oxime, cefuroxime resistance rate of more than 80%. Conclusion The clinical features of early onset and late onset neonatal sepsis are different. Early diagnosis should be based on perinatal infection, local infection and laboratory tests, and rational selection of antibiotics should be based on the distribution of pathogens in this area.