新生儿无乳链球菌败血症临床分析

Clinical analysis of 11 cases of neonatal streptococcus agalactiae sepsis

目的:探讨新生儿无乳链球菌败血症的临床特点及耐药性。方法:对11例新生儿无乳链球菌败血症患儿的临床资料和治疗结果进行回顾性分析。结果:2012年确诊新生儿败血症25例中无乳链球菌感染占44.0%,其中早发败血症7例,晚发败血症4例;临床表现发热6例,黄疸5例,肺炎5例(早发感染占4例),颅内感染4例(晚发感染占3例);所有血培养对青霉素、头孢类抗生素和万古霉素均无耐药性,对四环素耐药100.0%,对克林霉素耐药72.7%。结论:无乳链球菌败血症早发感染临床以呼吸道表现为主,晚发感染常合并颅内感染,需注意完善脑脊液检查。治疗上首选青霉素、头孢菌素,克林霉素耐药性高不宜临床选用。

Objective：To investigate the neonatal streptococcus agalactiae sepsis clinical characteristics and resistance in order to guide clinical treatment.Methods：The clinical features and resistance of 11 neonatal streptococcus agalactiae sepsis which admitted in our hospital from January 2012 to December 2012 were retrospectively analyzed.Results：25 cases neonatal sepsis were diagnozed in 2012,streptococcus agalactiae infections accounted for 44%,including 7 cases of early-onset sepsis,4 cases of late-onset sepsis.Clinical manifestations： 6 cases got fever,5 cases got jaundice,5 cases got pneumonia（including 4 cases of early-onset infection）,4 cases got intracranial infection（including 3 cases late-onset infection）.All blood cultures had no resistance to penicillin,cephalosporins and vancomycin,100% resistance to tetracycline,72.7% resistance to clindamycin.Conclusion：The trend of streptococcus agalactiae sepsis is growing in 2012,early-onset infection is often associated with respiratory symptoms,late-onset infection is often associated with intracranial infection,we need to pay attention to improve the cerebrospinal fluid examination.We can choose penicillin,cephalosporin for treatment.Clindamycin is not suitable for clinical use because of its high resistance.