新生儿败血症70例临床特征及病原菌分析

Analysis of Clinical Characteristics and Pathogenic Bacteria of 70 Cases with Neonatal Septicemia

目的探讨新生儿败血症的临床特征及病原菌情况。方法对2008年8月-2010年6月滁州市第一人民医院新生儿病房住院的70例新生儿败血症的临床资料及病原菌、药敏结果进行回顾性分析。结果新生儿败血症临床表现多不典型,多表现为病理性黄疸33例(占47.1%),不吃少吃46例(占65.7%),反应差20例(占28.6%),体温异常18例(占25.7%)等,病原菌以凝固酶阴性葡萄球菌为主,53例(占75.7%),其中表皮葡萄球菌28例(占40%),对青霉素、氨苄青霉素全部耐药,对万古霉素全部敏感,对克林霉素敏感率较高。均予综合治疗,治愈36例,好转25例,9例自动出院。结论新生儿败血症是严重危害新生儿健康的疾病,临床表现缺乏特异性,病原菌以凝固酶阴性葡萄球菌为主,对于可疑败血症患儿应早期进行血培养确定病原菌,并根据本地最可能的病原菌选用相关抗生素。

Objective To study the clinical characteristics and pathogenic bacteria of neonatal septicemia. Methods Seventy hospitalized newborns with septicemia from Aug. 2008 to Jun. 2010 were included in this study. The clinical data, pathogenic bac- teria and the test results of antimicrobial susceptibility were analyzed retrospectively. Results Clinical manifestations of neonatal septicemia were not typical. Among the studied cases, there were 33 cases of physiologic jaundice（47.1% ） ,46 cases of anorexia （65.7%） ,20 cases of bad responce （28.6%）, 18 cases of abnormal body temperature （25.7%）. The main pathogenic bacteria were coagulase negative Staphylococcus （53 cases,75.7 % ）, in which 28 cases （40%） were staphylococcus epidermidis. All cases showed the resistance to penicillin and ampicillin penicillin, but sensitive to ancomycin, and with high sensitive rate to klingen- berg. The comprehensive treatment was performed in all cases,and 36 cases were cured,25 cases were greatly improved,9 cases left hospital without cure. Conclusion Neonatal septicemia is a disease that can seriously harm the health of neonates. The clinical manifestations of this disease were not specific. Among the isolated pathogenic bacteria, the most common one was coagulase negative Staphylococcus. An early blood culture should be taken from any newborn infant who is suspected of neonatal septicemia, and empirical use of appropriate antibiotics should be initiated as soon as the blood specimen for culture has been drawn.