新生儿早发型B族链球菌败血症16例临床分析

Clinical Analysis of 16 Cases of Neonatal Early-onset Group B Streptococcus Sepsis

目的：探讨早发型新生儿B族链球菌（GBS）败血症的临床特征及治疗方法。方法：回顾性分析2011年1月至2013年10月我院新生儿科收治的16例新生儿早发性GBS败血症病例,分析临床特点、治疗方法和预后。结果：16例早发型GBS败血症中足月儿8例,早产儿8例;1 h内起病9例,均表现为呼吸困难,临床合并肺炎,有发生持续肺动脉高压可能;1~3 d起病7例,临床表现以败血症或化脓性脑膜炎为主;并发肺炎12例、休克5例、化脓性脑膜炎3例（均为足月儿）。药敏试验显示GBS对青霉素、氨苄西林、头孢曲松、万古霉素等敏感。死亡3例,均为超低出生体质量儿（生后72 h内死亡）;脑积水1例,腹腔引流术后,确诊脑瘫;1例脑室扩大。结论：早发型GBS败血症早期起病以呼吸道表现为主,1~3 d起病以败血症及颅内感染为主要表现,有导致神经系统后遗症及死亡可能。

Objective： To investigate clinical characteristics and treatments of neonatal early-onset group B streptococcus （GBS） sepsis. Methods： The clinical characteristics, treatments and prognosis of 16 children who were diagnosed as neonatal early-onset GBS sepsis were retrospectively analyzed from January 2011 to October 2013. Results： Sixteen children including 8 cases of term infants and 8 cases of premature infants were diagnosed neonatal early-onset GBS sepsis. Nine cases of children who attacked in one hour had respiratory symptoms that might result in persistent pulmonary hypertension. Seven cases of children who attacked in 1 - 3 days had clinical performances of sepsis and meningitis. Twelve cases had pneumonia, five cases had shock and three cases had purulent meningitis. The results of drug resistance displayed that GBS were sensitive to penicillin, atnpicillin, cefiriaxone and vancomycin. Three extremely low birth weight infants died including one case hydrocephalus, one case ventriculomegaly. Conclusions： The main clinical performance of neonatal early-onset GBS sepsis was respiratory symptoms and was sepsis and tracranial infection attacked in 1 -3 days. Some infants had neurologic impairment and died.