梅州地区足月儿与早产儿新生儿败血症临床特征及病原学特点比较

Comparison of Clinical Characteristics and Etiological Characteristics Between Full-Term Infants and Premature Infants with Sepsis in Meizhou Area

目的比较梅州地区新生儿败血症患儿中足月儿与新生儿的临床特征和病原学特点。方法收集梅州市人民医院于2017年7月—2019年8月期间确诊为新生儿败血症的患儿共66例,按照新生儿胎龄是否满37周将败血症患儿分为早产儿组和足月儿组,对两组的危险因素、临床表现、实验室检查指标、病原菌等进行比较。结果早产儿组窒息、胎膜早破>18 h比率高于足月儿组,足月儿组中羊水粪染的患儿比例高于早产组(P<0.05)。早产儿组早发型败血症率高于足月儿组,晚发型败血症比例低于足月儿组(P<0.05)。早产儿组呼吸异常例数多于足月儿组,但发热例数少于足月儿组,并发颅内感染发生率低于足月儿组(P<0.05)。早产儿组致病菌以革兰氏阴性菌为主,多见肺炎克雷伯菌;足月儿组以革兰阳性菌为主,多见无乳链球菌。结论可依早产儿、足月儿及临床特征、病原学检查确定败血症,予相应干预。

Objective To compare the clinical and etiological characteristics of full-term infants and neonates in neonates with sepsis in Meizhou Area.Methods A total of 66 children diagnosed with neonatal septicemia in Meizhou People’s Hospital from July,2017 to August,2019 were collected.According to whether the neonatal gestational age had reached 37 weeks,the septicemia children were divided into the premature group and the full-term group.The risk factors,clinical manifestations,laboratory examination indicators and pathogenic bacteria of the two groups were compared.Results The rate of suffocation and premature rupture of membranes>18 h in the premature group was higher than that in the full-month group,and the proportion of amniotic fluid fecal contamination in the full-month group was slightly higher than that in the premature group(P<0.05).The premature sepsis rate was higher than that of the full-term group,and the late sepsis rate was lower than that of the full-term group(P<0.05).The number of respiratory abnormalities in the premature group was higher than that in the full-month group,but the number of fever cases was lower than that in the full-month group,and the incidence of intracranial infection was lower than that in the full-month group(P<0.05).The pathogenic bacteria of premature infants were mainly gram-negative bacteria,and klebsiella pneumoniae was more common.The full moon group was dominated by gram-positive bacteria,most of which were streptococcus agalactis.Conclusion Sepsis can be determined according to preterm and term infants,clinical characteristics,and etiological examination.