新生儿早发型李斯特菌败血症12例临床分析

Clinical analysis of early onset sepsis caused by Listeria monocytogenes in 12 neonates

目的探讨新生儿早发型李斯特菌败血症的临床特点及诊治。方法回顾分析2011年1月至2018年6月新生儿科收治的12例早发型血培养为单核细胞增生性李斯特菌患儿的临床资料。结果 12例患儿中男8例、女4例,10例为早产儿。临床表现为体温异常,呼吸急促、窘迫或呼吸暂停,惊厥,皮疹及肺出血等。血培养为李斯特菌,其中1例脑脊液培养也为李斯特菌。治疗上予单用或联合美罗培南、青霉素类及万古霉素等抗感染。好转4例,死亡8例。结论新生儿李斯特菌败血症是一类极其严重的感染性疾病,起病急,感染重,病死率高。

Objective To explore the clinical characteristics, diagnosis and treatment of early onset sepsis caused by Listeria monocytogenes in neonates. Methods The clinical data of early onset sepsis with positive blood culture of Listeria monocytogenes in 12 neonates admitted to NICU from January 2011 to June 2018 were retrospectively analyzed. Results Among the 12 cases, 8 were males, 4 were females, and 10 were premature. The main clinical manifestations were abnormal body temperature, shortness of breath, distress or apnea, convulsions, rashes and pulmonary hemorrhage. Blood culture results showed Listeria, and Listeria was also found in cerebrospinal fluid culture in one case. The antibiotics, including meropenem, penicillins and vancomycin, were used alone or in combination, and 4 cases were improved and 8 cases died. Conclusion Neonatal sepsis caused Listeria monocytogenes is a very serious infectious disease, which is characterized by acute onset, severe infection and high mortality.