新生儿早发型细菌感染的病原学分析  

Etiology of early-onset neonatal bacterial infection

作　　者：罗娅莎[1] 白娜 邓文喻[1] 卢春敏[1] 钟峰 穆小萍[1] Luo Yasha;Bai Na;Deng Wenyu;Lu Chunmin;Zhong Feng;Mu Xiaoping(Department of Clinical Laboratory,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Pediatrics,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院检验科,广州511400 [2]广东省妇幼保健院儿科,广州511400

出　　处：《国际医药卫生导报》2021年第16期2569-2573,共5页International Medicine and Health Guidance News

摘　　要：目的分析新生儿早发型细菌感染的常见类型及病原谱分布,为临床预防和经验性治疗提供合理的依据。方法对2016至2019年期间于广东省妇幼保健院就诊的出生72 h内的新生儿送检细菌培养的标本与结果进行分析,并对其母亲围生期病原学检查结果进行回顾。结果共纳入351例新生儿,分离出的373株病原菌,分别来自血培养(202株,54.2%)、痰液(63株、16.9%)、胃内容物(58株、15.5%)、中段尿(27株、7.2%)、眼分泌物(11株、2.9%)、气管导管(10株、2.7%)和腹水(2株、0.6%)。共分离出41种病原菌,最常见的为大肠埃希菌(97株、26.0%),其次是无乳链球菌(76株、20.4%)、表皮葡萄球菌(39株、10.5%)、溶血葡萄球菌(23株、6.2%)、肺炎克雷伯菌(22株、5.9%)。有43名母亲发生过围生期感染,且病原菌与其新生儿一致,包括无乳链球菌、大肠埃希菌、白色念珠菌、肺炎克雷伯菌、产单核李斯特菌、解没食子酸菌链球菌、热带念珠菌及粪肠球菌,分离自宫颈、胎膜、血培养和羊水。结论大肠埃希菌、无乳链球菌、肺炎克雷伯菌、产单核李斯特菌、念珠菌等是引起新生儿早发型细菌感染的重要病原菌,它们可通过母婴垂直传播引起新生儿败血症、肺炎、泌尿道感染、结膜炎等疾病,建议孕产妇在围生期及临产前送检宫颈分泌物病原学检查,妊娠过程中出现不明原因高热应及时排除产单核李斯特菌感染,孕产妇的病原学结果将对新生儿经验性用药提供重要的参考依据。Objective To analyze the types and pathogen spectrum of early-onset neonatal bacterial infection,and to provide the basis for clinical prevention and empirical treatment.Method This was a retrospective study aimed at addressing the composition of pathogens of early-onset neonatal bacterial infection and their mothers in Guangdong Women and Children Hospital between 2016 and 2019.Results A total of 351 newborns were included in this study,and 373 strains of bacteria were isolated from their blood(202 strains,54.2%),sputum(63 strains,16.9%),gastric aspirate(58 strains,15.5%),midstream urine(27 strains,7.2%),eye secretion(11 strains,2.9%),tracheal catheter(10 strains,2.7%),and peritoneal effusions(2 strains,0.6%).A total of 41 species of bacteria were obtained,the most common bacteria were Escherichia coli(97 strains,26.0%),Streptococcus agalactiae(76 strains,20.4%),Staphylococcus epidermidis(39 strains,10.5%),Staphylococcus haemolyticus(23 strains,6.2%),and Klebsiella pneumoniae(22 strains,5.9%).There were 43 mothers who had developed perinatal infection,and the pathogens were the same as their newborns,which included Streptococcus agalactiae,Escherichia coli,Candida albicans,Klebsiella pneumoniae,Listeria monocytogenes,Streptococcus gallinolyticus,Candida tropicalis,and Enterococcus faecalis,isolated from cervix,fetal membrane,blood culture,and amniotic fluid.Conclusions Escherichia coli,Streptococcus agalactiae,Klebsiella pneumoniae,Listeria monocytogenes,and Candida are the important pathogens causing early-onset neonatal bacterial infection,which can lead to neonatal sepsis,pneumonia,urinary tract infection,conjunctivitis,and other diseases through vertical transmission from mother to child.We suggest that the cervical swab of pregnant women should be collected during the perinatal period for pathogen detection,and Listeria monocytogenes infection should be excluded in time if unexplained high fever occurs during pregnancy.The etiological results of mothers will provide important evidences for empirical treatme

关 键 词：新生儿 早发型细菌感染 围生期感染 败血症 

分 类 号：R446.5[医药卫生—诊断学] R722.13[医药卫生—临床医学]