新生儿败血症159例临床分析  

Clinical analysis of 159 cases of neonatal septicemia

作　　者：董青艺[1] 陈平洋[1] 谢宗德[1] 李雯[1] 贺晓日[1] 

机构地区：[1]中南大学湘雅二医院新生儿科,湖南长沙410011

出　　处：《中国现代医学杂志》2011年第28期3558-3561,3565,共5页China Journal of Modern Medicine

摘　　要：目的分析新生儿败血症的临床特点,病原菌培养情况及院内感染的相关因素,为早期诊治提供依据。方法对中南大学湘雅二医院159例新生儿败血症的临床资料、病原菌情况、院内感染的相关因素以及治疗预后情况进行回顾性研究。结果①新生儿败血症发生率占同期住院患儿的6.32%,其中院内感染占18.87%。②病原菌以凝固酶阴性葡萄球菌、肺炎克雷伯氏菌和真菌为主。凝固酶阴性葡萄球菌对青霉素及苯唑青霉素高度耐药;肺炎克雷伯氏菌对亚胺培南敏感。③早产、低出生体重、中心静脉置管、机械通气及广谱抗生素联合使用为院内感染的高危因素。结论新生儿败血症以条件致病菌为主,应加强护理,注意隔离,严格无菌操作以及合理使用抗生素,减少新生儿败血症及其并发症的发生。【Objective】To study the clinical characteristics and pathogens of neonatal septicemia,and risk factors for nosocomial infection to provide evidence for early diagnosis and treatment.【Methods】A retrospective study including clinical data,pathogens and drug sensitivity test,risk factors for nosocomial infection,treatment and prognosis,was made in 159 cases of neonatal septicemia.【Results】The incidence of neonatal septicemia in hospitalized children was 6.32%,of which 18.87% was nosocomial infection.Coagulase-negative staphylococcus,Klebsiella pneumoniae and Candida were the main pathogens.Coagulase-negative staphylococci were highly resistant to Penicillin and Benzylpencilline.Imipenem was sensitive antibiotics for Klebsiella pneumoniae presently.Preterm,low birth weight,peripherally inserted central venous catheters,mechanical ventilation and multi-antibiotics treatment were significant risk factors for nosocomial infection.【Conclusion】Opportunistic bacteria are the most commonly pathogens for neonatal septicemia.Possible strategies to be considered include barrier nursing,strict aseptic manipulation and rational use of antibiotics to prevent neonatal septicemia and its complication.

关 键 词：新生儿 败血症 院内感染 病原菌 药物敏感试验 

分 类 号：R722.131[医药卫生—儿科]