NICU早产与足月新生儿败血症特点对比研究  

A comparative study of features of acquired septicemia between premature and full-term newborns in NICU

作　　者：钟巧[1] 李晖[1] 高晓玲[1] 刘珺[1] 杨传忠[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院医院感染管理科,广东深圳518028

出　　处：《中华医院感染学杂志》2014年第1期211-213,共3页Chinese Journal of Nosocomiology

基　　金：深圳市科技局基金资助项目(201102088)

摘　　要：目的对新生儿重症监护病房(NICU)早产与足月新生儿感染败血症特性进行对比研究,为早期发现和合理治疗提供帮助。方法医院NICU 2009年1月-2012年12月确认败血症115例,分为早产儿与足月新生儿两组,对比研究临床特征和病原菌特点、主要病原菌对常用抗菌药物耐药率,细菌鉴定严格按照《全国临床检验操作规程》进行。结果两组患儿末梢凉、反应差、皮肤颜色改变进行比较,差异有统计学意义(P<0.05);血常规对感染诊断意义不大;两组早产儿及足月新生儿检出病原菌中革兰阳性球菌分别占64.2%及84.1%,革兰阴性杆菌分别占35.8%及15.9%;凝固酶阴性葡萄球菌对常用抗菌药物耐药率早产儿均高于足月儿,其对万古霉素、替考拉宁和利奈唑胺敏感,耐药率均<20.0%。结论了解早产与足月新生儿败血症临床和病原菌不同的特性,能为早期发现、及时治疗、合理使用抗菌药物和经验用药提供重要依据。OBJECTIVE To compare and study the features of septicemia between the premature and full term newborns in neonatal intensive care unit（NICU）so as to guide the diagnosis and treatment.METHODS Totally 115 neonates who were confirmed with septicemia in the NICU from Jan.2009to Dec.2012were enrolled in the study and were divided into the premature newborn group and the full term newborn group,then the clinical features, distribution of pathogens,and drug resistance rates of the main pathogens to the commonly used antibiotics were observed and compared,and the bacterial identification was performed in strict accordance with National Clinical Laboratory Operation Procedures.RESULTS The difference in the cool endings,poor reaction,or change of skin color between the two groups was significant（P0.05）.It was of little significance of blood routine test to indicate the infection.The gram-positive cocci accounted for 64.2%among the pathogens isolated from the premature newborns,84.1%from the full term newborns;the gram-negative bacilli accounted for 35.8% and 15.9%,respectively.The drug resistance rates of coagulase-negative Staphylococci isolated from the premature newborns to the commonly used antibiotics were higher than that of those isolated from the full term newborns,the strains were highly susceptible to vancomycin,teicoplanin,and linezolid,with the drug resistance rates less than 20.0%. CONCLUSIONTo understand the clinical features of the premature or full-term newborns with septicemia and the distribution of pathogens may contribute to the early diagnosis,timely treatment,and reasonable use of antibiotics as well as empirical medication.

关 键 词：新生儿重症监护病房 败血症 病原菌 早产儿 

分 类 号：R181.32[医药卫生—流行病学]