早产儿肺炎克雷伯杆菌感染75例分析  

Analysis of Klebsiella pneumoniae infection in 75 preterm infants

作　　者：花少栋[1] 李秋平[1] 黄婕婷[1] 吴志新[1] 封志纯[1] 

机构地区：[1]中国人民解放军北京军区总医院附属八一儿童医院新生儿重症监护中心,100700

出　　处：《中华围产医学杂志》2012年第2期95-100,共6页Chinese Journal of Perinatal Medicine

摘　　要：目的分析早产儿肺炎克雷伯杆菌感染的临床特点。方法回顾性分析2008年2月6日至2010年2月10日本院早产儿病房75例肺炎克雷伯杆菌感染早产儿临床资料。采用两独立样本t检验比较早发型与晚发型肺炎克雷伯杆菌感染辅助检查指标的差异。采用Spearman相关分析以及非条件Logistic回归分析早产儿肺炎克雷伯杆菌感染的高危因素及预后的影响因素。结果同期住院早产儿共272l例，发生肺炎克雷伯杆菌感染75例，发生率2．8％，病死率9．3％（7／75）。75例患儿中诊断肺炎克雷伯杆菌败血症71例，肺炎克雷伯杆菌肺炎4例。早发型感染（发病日龄≤72h）63例，晚发型感染（即医院感染，发病日龄〉72h）12例。均有反应差、安静状态心率〉160次／min和血氧饱和度下降。早发型肺炎克雷伯杆菌感染患儿平均红细胞体积为（128．87±24．60）fl，平均红细胞血红蛋白含量为（38．11±2．15）pg，均高于晚发型患儿[分别为（113．72±13．54）fl和（36．98±1．05）pg]，差异均有统计学意义（t分别为-2．07和-2．76，P均〈0．05）。低出生体重和剖宫产与早发型肺炎克雷伯杆菌败血症相关（r分别为0．250和-0．240，P〈O．05）。肺炎克雷伯杆菌感染患儿的预后与住院时间及胎膜早破时间相关（r分别为0．368和0．318，P〈0．05）。结论早产儿肺炎克雷伯杆菌感染临床表现非特异，对有剖宫产、低出生体重、孕母胎膜早破时间长、接受侵袭性操作者，应警惕肺炎克雷伯杆菌感染的可能。Objective To analyze the clinical characteristics of Klebsiella pneumoniae infection in preterm infants. Methods Clinical data of 75 preterm infants infected with Klebsiella pneumoniae treated in BaYi Children＇s Hospital from February 6, 2008 to February 10, 2010 were retrospectively analyzed. The difference of auxiliary examination between early-onset and late-onset infection group were compared by two independent samples t test. Spearman correlation analysis and non-conditional Logistic regression analysis were used to analyze the high risk factors and the prognostic factors of Klebsiella pneumoniae infection in preterm infants. Results The incidence of Klebsiella pneumoniae infection was 2.8± （75/2721） in preterm infants, and the mortality rate was 9.3M （7/75）. There were 71 cases of Klebsiella pneumoniae sepsis and 4 cases of Klebsiella pneumoniae pneumonia. Among 75 cases, 63 cases were early-onset infection （onset age72 h） and 12 were late-onset infection （onset age72 h）. All patients presented with poor response, heart rate during quiet sleep ~ 160/min and low oxygen saturation. The mean corpuscular volume and mean corpuscular hemoglobin concentration in early-onset Klebsiella pneumoniae infection cases were higher than those in late-onset neonates [-（128.87±24.60） fl vs （113.72±13.54） fl, t= -2.07, P〈0.05 and （38.11±2.15） pgvs （36.98±1.05） pg, t=--2.76, P〈0.051. Low birth weight and caesarean section were associated with early-onset Klebsiella pneumoniae sepsis （r= 0. 250 and --0. 240, P% 0.05）. The prognosis of Klebsiella pneumoniae infection was associated with hospital stay and duration of premature rupture of membranes （r=0. 368 and 0. 318, P〈0.05）. Conclusions There were no specific clinical manifestations for Klebsiella pneurnoniae infection in preterm infants. Preterm infants with low birth weight, long duration of premature rupture of membranes, delivered by caesarean section and received invasive operation are likely to develop Klebsiella pneum

关 键 词：婴儿 早产 克雷伯菌 肺炎 克雷伯菌感染 

分 类 号：R446.5[医药卫生—诊断学]