2019-2022年某院新生儿无乳链球菌医院感染血清分型及其流行病学

Serotypes and epidemiological characteristics of Streptococcus agalactiae causing nosocomial infection in neonates from 2019 to 2022

目的探讨新生儿无乳链球菌医院感染血清分型及其流行病学.方法回顾性分析15458例2019年1月-2022年12月于商丘市第一人民医院出生的新生儿的临床资料,统计新生儿无乳链球菌感染标本来源,不同年份、病区、胎龄、性别、分娩方式、出生体质量新生儿无乳链球菌感染情况,新生儿无乳链球菌感染血清分型及耐药情况等.结果2019-2022年15458例新生儿发生无乳链球菌感染63例,感染率为0.41%.标本来源以血液(+)、痰液(+)、脑脊液(-)检出无乳链球菌占比最高.与2019年比,2022年新生儿无乳链球菌感染率较低(P<0.05).与新生儿普通病房比,早产儿、足月儿重症加强护理病房(ICU)无乳链球菌感染率升高,足月儿ICU高于早产儿ICU(P<0.05).与37~<42周胎龄新生儿比较,32~<37周和≥42周胎龄新生儿无乳链球菌感染率较低(P<0.05);与剖宫产新生儿比较,阴道分娩新生儿无乳链球菌感染率较高(P<0.05);与1.5~<2.5 kg新生儿比较,2.5~<4.0 kg和≥4.0 kg新生儿无乳链球菌感染率较低(P<0.05).63例无乳链球菌感染新生儿血清分型以Ⅲ型、Ⅰb型、Ⅴ型占比最高.无乳链球菌对红霉素、四环素、克林霉素的耐药率较高.结论与2019年比,2022年新生儿无乳链球菌感染率较低,医院应针对新生儿具体情况采取防控措施,以降低新生儿无乳链球菌的感染率.

OBJECTIVE To explore the serotypes and epidemiological characteristics of Streptococcus agalactiae causing nosocomial infection in neonates.METHODS The clinical data of 15458 neonates who were born in Shangqiu First People's Hospital from Jan 2019 to Dec 2022 were retrospectively analyzed.The specimen sources,years,gestational age,gender,delivery mode,birth weight and prevalence of S.agalactiae were statistically analyzed.RESULTS Among the 15458 neonates who were born from 2019 to 2022,63 had S.agalactiae infection,with the infection rate 0.41%.The blood(+),sputum(+)and cerebrospinal fluid(-)were the major specimen sources.The incidence of S.agalactiae infection was significantly lower in 2022 than in 2019(P<0.05);the incidence of S.agalactiae infection of the preterm,full-term infant was significantly higher in the intensive care unit(ICU)than in the common neonatal ward,which was higher in the ICU of full-term infants than in the ICU of preterm infants(P<0.05).The incidence rate of S.agalactiae infection was significantly lower in the neonates with the gestational age between 32 and 37 weeks and the gestational age no less than 42 weeks than in the neonates with the gestational age between 37 and 42 weeks(P<0.05).The incidence rate of S.agalactiae infection was significantly higher among the neonates with vaginal delivery than among the neonates with cesarean section(P<o.05).The incidence rate of S.agalactiae infection was significantly lower in the neonates with the birth weight between 2.5 and 4.0 kg and the weight no less than 4.0 kg than in the neonates with the birth weight between 1.5 and 2.5 kg(P<0.05).TypeⅢ,typeⅠb and typeⅤwere the major serotypes among the 63 neonates with S.agalactiae infection.The drug resistance rates of the S.agalactiae to erythromycin,tetracycline and clindamycin were relatively high.CONCLUSION The incidence rate of S.agalactiae infection of the neonates is lower in 2022 than in 2019.It is necessary for the hospital to take prevention measures based on the specific circumstance of the neonates so as to reduce the incidence of S.agalactiae infection.