新生儿B族溶血链球菌败血症临床特征分析

Clinical analysis of neonatal sepsis caused by group B streptococcus

目的探讨新生儿B族链球菌(group B streptococcus,GBS)败血症早发型和晚发型的临床特征。方法将2013年1月—2017年10月苏州大学附属儿童医院新生儿科收治的26例GBS败血症患儿,分为早发型(生后≤7d发生)16例和晚发型(生后>7d发生)10例,对两组患儿一般资料、临床表现、实验室检查、治疗及转归情况进行回顾性分析。结果早发型败血症组胎龄、出生体重低于晚发型,发热及化脓性脑膜炎比例低于晚发型,差异有统计学意义(P<0.05)。26例患儿血培养药敏均对青霉素和万古霉素敏感。经积极抗感染治疗后治愈24例,未愈及好转各1例均为晚发型。结论早发型GBS败血症患儿起病急,临床症状典型,预后相对较好;晚发型GBS败血症起病较隐匿,且多合并化脓性脑膜炎,易发生神经系统后遗症。

Objective To investigate the clinical manifestations of early and late neonate sepsis of group B streptococcus(GBS). Methods The neonates with GBS sepsis admitted to the department of neonatology of Children’s Hospital of Soochow University from January 2013 to October 2017 were divided into two groups:16 cases of early onset group(onset≤7 days after birth)and 10 cases of late onset group(onset>7 days after birth).The general data,clinical manifestations,laboratory examination,treatment and outcome of the two groups of children were retrospectively analyzed. Results The gestational age and birth weight of the early onset group were lower than those of the late onset group,and the percentage of febrile and purulent meningitis were lower than those of the late onset group,and the differences were statistically significant(P<0.05).All 26 children were sensitive to penicillin and vancomycin by blood culture for drug sensitivity test.After active anti-infection treatment,24 cases were cured,the late onset group had one uncured case and one improved case. Conclusion The early onset type of GBS sepsis is acute and has typical clinical symptoms and relatively good prognosis.Late onset type of GBS sepsis is more insidious and is often associated with purulent meningitis which is prone to neurological sequelae.