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目的分析新生儿沙雷菌感染的临床特征及预后,提高对沙雷菌感染的认识。方法对2008年7月-2009年2月在本院新生儿中心住院的4例沙雷菌感染新生儿的临床表现、实验室检查、诊断、并发症、治疗及预后进行分析。结果4例患儿中3例血培养为黏质沙雷菌(其中早产儿1例),1例脑脊液培养为液化沙雷菌。4例患儿的主要临床表现为发热、抽搐、反应差,外周血白细胞和CRP显著增高,其中1例早产儿以血小板减少为著。2例单纯败血症患儿,经至少2周的三代头孢菌素抗炎治疗后,治愈;另2例败血症合并细菌性脑膜炎患儿,1例为早产儿,1例为液化沙雷菌感染,影像学证实合并脑膜脑炎及脑脓肿,随访有神经行为异常。结论沙雷菌作为一种条件致病菌,可引起严重的新生儿感染。合并脑膜炎者,应监测随访,注意高发的神经系统后遗症。
Objective To analyze the clinical characteristics and prognosis of Serratia in neonates and to improve the understanding of Serratia infection. Methods The clinical manifestations, laboratory tests, diagnosis, complications, treatment and prognosis of 4 newborns infected with Serratia in hospital from July 2008 to February 2009 in our neonatal center were analyzed. Results Among 4 children, 3 were Serratia marcescens (1 in preterm infants) and 1 in CSF were Serratia marcescens. The main clinical manifestations of 4 children were fever, convulsions, poor response, peripheral white blood cells and CRP were significantly higher, of which 1 case of premature children with thrombocytopenia. 2 cases of simple sepsis in children, after at least two weeks of third-generation cephalosporin anti-inflammatory treatment, cured; the other 2 cases of sepsis with bacterial meningitis in children, 1 case of premature children, 1 case of Serratia liquefacient infection, Imaging confirmed meningoencephalitis and brain abscess, follow-up with neurological abnormalities. Conclusion Serratia bacteria as a condition of pathogens, can cause severe neonatal infection. Merger meningitis, follow-up should be monitored, pay attention to the high incidence of nervous system sequelae.