40例新生儿B族链球菌败血症临床特征及药物敏感性分析

Analysis of clinical characteristics and drug sensitivity of 40 neonates with group B Streptococcus septicemia

目的:探讨新生儿B族链球菌(group B Streptococcus,GBS)败血症的临床特征及药物敏感情况,为临床诊治提供理论依据。方法:选取2010年1月—2020年12月在汕头大学医学院第一附属医院诊断为新生儿GBS败血症的40例患儿作为研究对象,根据发病时间分为早发型(29例)和晚发型(11例),对患儿的临床资料进行回顾性分析。结果:早发型患儿呼吸道感染(62.07%)、弥散性血管内凝血(44.83%)、肌酸激酶同工酶升高(41.38%)、低钙血症(37.93%)、呼吸衰竭(34.48%)、肌酐升高(34.48%)、颅内出血(31.03%)发生率均高于晚发型患儿(P<0.05)。晚发型患儿发热(63.64%)、颅内感染(54.55%)发生率均高于早发型患儿(P<0.05)。药物敏感试验结果显示,GBS对阿奇霉素、克林霉素、四环素、米诺环素的耐药性高,而对青霉素、万古霉素、阿莫西林、利奈唑胺的敏感性高。结论:早发型新生儿GBS败血症临床主要表现为呼吸道感染,晚发型则主要表现为发热和颅内感染。GBS对青霉素、阿莫西林、万古霉素等抗菌药物的敏感性高。

Objective:To investigate the clinical characteristics and drug sensitivity of neonatal group B streptococcus(GBS)septicemia,and to provide a theoretical basis for clinical diagnosis and treatment.Methods:From January 2010 to December 2020,40 children diagnosed with neonatal GBS septicemia in the First Affiliated Hospital of Shantou University Medical College were selected as the research objects.According to the time of onset,they were divided into early-onset(29 cases)and late-onset(11 cases),and the clinical data of the children were retrospectively analyzed.Results:The incidence of respiratory tract infection(62.07%),diffuse intravascular coagulation(44.83%),elevated creatine kinase isoenzyme MB(41.38%),hypocalcemia(37.93%),respiratory failure(34.48%),increased creatinine(34.48%)and intracranial hemorrhage(31.03%)in early-onset children were higher than those of late-onset children(P<0.05).The incidence of fever(63.64%)and intracranial infection(54.55%)in late-onset children were higher than those in early-onset children(P<0.05).The results of the drug sensitivity test showed that GBS is highly resistant to azithromycin,clindamycin,tetracycline,and minocycline,but is highly sensitive to penicillin,vancomycin,amoxicillin,and linezolid.Conclusion:The clinical manifestations of early-onset neonatal GBS septicemia are mainly respiratory tract infections,while the late-onset symptoms are mainly manifested as fever and intracranial infection.GBS is highly sensitive to antibacterial drugs such as penicillin,amoxicillin and vancomycin.