新生儿李斯特菌败血症临床分析

The clinical analysis of neonatal listeriosis

目的通过对新生儿李斯特菌败血症的临床表现、检查方法、治疗时机及用药、产母孕期情况的讨论及分析,提高对本病的认识,避免漏诊及延误治疗,以减少新生儿病死率。方法对2009年我科收治的6例确诊为李斯特菌感染的小儿进行病因、临床表现、治疗及预后分析和比较。结果本组6例全部为早产儿,均经血培养证实为产单核细胞李斯特菌。6例产母孕晚期均有发热,分别在发热不同时期结束妊娠,小儿临床症状轻重不一,均在生后使用敏感抗生素,预后良好。结论新生儿李斯特菌败血症一般病情较重、病死率较高。对于李斯特菌感染性疾病应从孕晚期孕妇保健及饮食宣教即开始,孕妇一旦出现发热等表现需要警惕李斯特菌感染,并高度关注病情变化并给予宫内抗感染治疗,并根据具体情况及早结束妊娠。同时对出生后的新生儿需要预防性或治疗性应用抗生素,并及时完善相关检查。李斯特菌病的早期监测及有效的针对性救治有助于提高患儿的存活率与改善预后。

Objective To increase the awareness of the neonatal listeriosis,avoid misdiagnosis and delay in treatment,and reduce neonatal mortality.Methods The cause,clinical manifestations,test methods,treatment and prognosis of the six children admitted in our department in 2009,confirmed by listeria monocytogenes,were retrospectively analyzed.Results All the six cases were preterm infants.Listeria monocytogenes were confirmed by blood culture.All the mothers of the six cases had fever in the third trimester of pregnancy.The children had varying severity of clinical symptoms and were treated with sensitive antibiotics after birth.The prognosis was good.Conclusions Neonatal listeriosis is generally serious and had high mortality rate.The informations about the listeria monocytogenes infectious disease should be delivered into the education of health and diet of pregnant women in late pregnancy.Early detection and effective treatment can be helpful to improve the survival rate of children and prognosis.