新生儿败血症106例临床分析

Clinical review of 90 cases neonatal septicemia

目的 :探讨近 10年新生儿败血症病原学的变化特点。方法 :比较 80年代组与 90年代组新生儿败血症的临床表现、血培养结果、药敏结果的异同点。结果 :80年代组以院外感染为主 (占81.6 7% ) ,90年代组院内感染增加达 6 5 .30 % ;皮肤、脐部及呼吸道感染始终是主要的感染途径。体温异常、喂养困难、精神差及黄疸、脐部炎症是两组均常见的临床表现。表皮葡萄球菌、金黄色葡萄球菌是主要的致病菌 ,90年代组耐甲氧西林金黄色葡萄球菌感染率明显上升。青霉素、红霉素及氨苄青霉素敏感率较低 ;β内酰胺酶抑制剂的抗生素 ,(优力新 ,头孢二、三代 )敏感性较高。 结论 :防治医院内获得性感染 ,是减少新生儿败血症发生的主要措施 ;随着致病菌的变化 。

Objective: To study the etiological change of neonatal septicemia and direct clinic treatment. Method: The patients with neonatal septicemia were divided into two groups , 1985～1990 and 1995～2000 . Compare clinic manifestations , blood culture , and drug sensitivity by statistical methods. Result: Infection in hospital was primary in 80s group(81.67%) . Infection out hospital made up 65.30 percent in 90s group . Skin, umbilicus, respiratory tract were primary route of infection.Abnormal temperature,feeding difficulty,listlessness, jaundice, umbilical inflammation were common clinical features. Staphylococcus epidermidis and staphylococcus aureus were primary pathogenic bacteria.MRSE infection rose in 90s group.Penicillin, erythromycin and ampicillin were lower sensitivity,but cephalosporin was higher .Conclusion: Treatment and prevention of infection in hospital were primary measure that reduced neonatal septicemia.The antibacterial with anti-β-lactanase was higher sensitivity.