母婴同室早发感染高危新生儿临床管理专家共识  

Expert consensus on clinical management of newborns at high risk of early-onset infection at rooming-in ward

作　　者：中国妇幼保健协会新生儿保健专业委员会 中国医师协会新生儿科医师分会 吴明远[2,5] 封志纯 杨杰[4,6] Neonatal Health Care Committee of Chinese Maternal and Child Health Association;Neonatology Society of Chinese Medical Doctor Association;Wu Mingyuan;Feng Zhichun;Yang Jie

机构地区：[1]不详 [2]浙江大学医学院附属妇产科医院新生儿科,杭州310006 [3]解放军总医院儿科医学部,北京100700 [4]广东省妇幼保健院新生儿科,广州511400 [5]浙江大学医学院附属妇产科医院 [6]广东省妇幼保健院

出　　处：《中华围产医学杂志》2021年第8期567-575,共9页Chinese Journal of Perinatal Medicine

摘　　要：新生儿早发感染(early-onset neonatal infection,EONI)是威胁新生儿生命健康的严重疾病,多种产科因素可增加EONI风险,如何管理EONI高危新生儿,既能有效预防和治疗EONI,又能尽量减少抗生素应用,是产科和新生儿科面临的巨大挑战。中国妇幼保健协会新生儿保健专业委员会和中国医师协会新生儿科医师分会组织成立专家组,通过文献检索和分析讨论形成具有证据等级的共识草案,并采用德尔菲法对各条共识进行匿名专家调查反馈及投票,制定了此共识。共识强调了产科和儿科间信息沟通和密切临床观察对EONI早期识别和防治的重要性。同时建议所有EONI高危新生儿应留院严密观察至少48 h;若新生儿出现感染症状,或新生儿无感染症状但存在母亲绒毛膜羊膜炎或侵袭性细菌感染,或同时存在≥2项高危因素包括母亲产时发热≥38℃、B族链球菌定植、胎膜早破≥18 h以及自发性早产时,建议转新生儿科进一步评价并预防性使用抗生素。Early-onset neonatal infection(EONI),which is influenced by multiple obstetric factors,remains a life-threatening problem for neonates.The optimal clinical management of high-risk newborns for the effective prevention or treatment of EONI,while minimizing neonatal antibiotics exposure,is a great challenge for both obstetricians and pediatricians.The Neonatal Health Care Committee of Chinese Maternal and Child Health Association and Neonatology Society of Chinese Medical Doctor Association organized an expert panel to develop an expert consensus on the clinical management of newborns at high risk of EONI in the rooming-in ward through literature review,analysis,discussion,evidence grading,and anonymous feedback and voting using the Delphi method.This expert consensus emphasized the importance of good communication between obstetric and pediatric departments and clinical observation for the early identification,prevention,and treatment of EONI.This consensus recommended that all newborns at high risk of EONI should be closely observed in the hospital for a minimum of 48 h;newborns with symptoms of infection,or asymptomatic but born to mothers with chorioamnionitis or invasive bacterial infection,or with two or more risk factors including intrapartum maternal fever(≥38℃),maternal group B streptococcal colonization,premature rupture of membranes≥18 h,or spontaneous preterm delivery,should be transferred to the neonatal care nursery for further evaluation and antibiotic prophylaxis.

关 键 词：细菌感染 母婴同室 危险因素 新生儿护理 抗生素预防 共识 

分 类 号：R473.72[医药卫生—护理学]