新生儿脓毒症致病菌分布及可溶性CD14亚型在早期诊断的意义

Distribution of pathogenic bacteria in septic children and the significance of sCD14-ST in early diagnosis

目的 评估新生儿脓毒症患儿血培养阳性致病菌的分布特点及可溶性CD14亚型(sCD14-ST)在早期诊断的价值。方法 检测2019年1~12月福建省龙岩市第一医院新生儿病房脓毒症患儿的血培养病原菌,分析sCD14-ST、白细胞、中性粒细胞百分比、血清C反应蛋白(CRP)等水平。结果 新生儿脓毒症患儿的基础疾病以新生儿呼吸窘迫综合征为主36.5%(19/52),足月儿致病菌以大肠埃希菌、金黄色葡萄球菌为主;早产儿致病菌以大肠埃希菌为主。三组sCD14-ST、血清CRP差异有统计学意义(P<0.05),白细胞与中性粒细胞百分比、PCT三组之间的差异无统计学意义(P>0.05);sCD14-ST在革兰氏阳性菌组、革兰氏阴性菌组中差异有统计学意义(P<0.01)。sCD14-ST和CRP的曲线下面积分别为(ROC^(AUC)=0.89、0.70),sCD14-ST的诊断敏感度为88.5%、诊断特异度为86.7%。结论 新生儿脓毒症患儿致病菌以大肠埃希菌为主,sCD14-ST在早期诊断中有指导价值。

Objective To investigate the distribution of positive pathogenic bacteria in blood culture of neonates with sepsis and the value of sCD14-ST in early diagnosis.Methods Detect the blood culture pathogens of septic children in the neonatal ward of the first hospital of Longyan City, Fujian Province from January 2019 to December 2019,and analyze the levels of sCD14-ST,WBC,N% and serum CRP.Results The basic diseases of neonatal sepsis mainly included neonatal respiratory distress syndrome, accounting for 36.5%(19/52).The pathogenic bacteria of term infants were mainly Escherichia coli and Staphylococcus aureus.Escherichia coli was the main pathogenic bacteria in premature infants. There was significant difference in sCD14-ST and serum CRP among the three groups(P<0.05),but there was no significant difference in WBC,N% or PCT(P>0.05).There was significant difference in sCD14-ST between Gram-positive bacteria group and Gram-negative bacteria group(P<0.01).The areas under the curve for sCD14-ST and CRP were(ROC^(AUC)=0.89,0.70),respectively. The diagnostic sensitivity and specificity of sCD14-ST were 88.5% and 86.7%.Conclusion Escherichia coli is the main pathogenic bacteria in neonatal sepsis.sCD14-ST has guiding value in early diagnosis.