新生儿解鸟氨酸拉乌尔菌败血症7例并文献复习  

Raoultella ornithinolytica neonatal sepsis:case report and literature review

作　　者：刘银芝[1] 杨慧[1] 廖镇宇[1] 杨志明[1] 叶红球[1] 占彩霞[1] 黄瑞文[1] Liu Yinzhi;Yang Hui;Liao Zhenyu;Yang Zhiming;Ye Hongqiu;Zhan Caixia;Huang Ruiwen(Department of Neonatology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院新生儿科,长沙410007

出　　处：《中华新生儿科杂志（中英文）》2022年第3期238-241,共4页Chinese Journal of Neonatology

摘　　要：目的探讨新生儿解鸟氨酸拉乌尔菌败血症的临床特征。方法回顾性分析湖南省儿童医院新生儿科2010年1月至2020年12月诊断为新生儿解鸟氨酸拉乌尔菌败血症患儿的临床资料,在PubMed、Web of Science、Embase数据库、万方数据库、中国期刊全文数据库、国家科技图书文献中心、中国科技论文在线检索新生儿解鸟氨酸拉乌尔菌败血症相关文献,检索时间均为建库至2020年12月31日,总结新生儿解鸟氨酸拉乌尔菌败血症临床特点及治疗情况。结果研究期间共确诊7例患儿,男6例,女1例,早产儿6例,足月小样儿1例。反应差6例,发热5例,呼吸困难3例。合并坏死性小肠结肠炎4例,先天性肠旋转不良、先天性空肠闭锁、肠粘连肠狭窄各1例,4例有手术史。白细胞增多3例,白细胞减少1例,均有血小板减少及炎性指标升高。7例患儿均治愈或好转出院。共纳入4篇文献4例新生儿,男3例,女1例,早产儿2例。皮肤潮红、呼吸困难各3例,发热2例,反应差1例。1例因先天性心脏病手术治疗。白细胞减少2例,白细胞增多1例,血小板减少2例,炎性指标升高3例。1例因感染性休克死亡,其余3例均治愈或好转出院。结论新生儿解鸟氨酸拉乌尔菌败血症多发生于合并肠道疾患、有手术等侵袭性操作病史、抵抗力低下的早产或足月小样儿以及合并先天性畸形的新生儿,多数抗感染治疗效果好,如合并感染性休克预后不良。Objective To study the clinical characteristics of neonatal sepsis caused by raoultella ornithinolytica.Methods From January 2010 to December 2020,clinical data of seven cases of neonates with raoultella ornithinolytica sepsis in the Department of Neonatology of our hospital were analyzed.Literature published from the establishment of the databases to December 31,2020 were searched and reviewed on this topic.The databases included PubMed,Web of Science,Embase database,Wanfang Database,CNKI,National Science and Technology Library and Chinese Science Paper Online.Results Among the 7 cases admitted to our hospital,6 male and 1 female,6 premature and 1 full-term small-for-gestational-age(SGA),6 patients presented with lethargy,5 patients had fever and 3 showed dyspnea.4 patients had necrotizing enterocolitis(NEC),1 congenital intestinal malrotation,1 congenital jejunal atresia,1 intestinal adhesion and stricture.4 patients had history of surgery.Leucocytosis was found in 3 cases and leukopenia in 1 case.Thrombocytopenia and increased inflammatory indicators were found in all cases.All 7 patients recovered and were discharged.4 articles on 4 newborn cases(3 males,1 female including two premature infants)were found for literature review.3 cases had skin flushing,3 cases showed dyspnea,2 cases had fever and 1 case presented with lethargy.1 case received surgery for congenital heart disease.Leucocytosis was found in 2 cases,leukopenia in 1 case,thrombocytopenia in 2 cases and elevated inflammatory indicators in 3 cases.1 patient died due to septic shock and the other three recovered and were discharged.Conclusions Raoultella ornithinolytica neonatal sepsis may occur in infants with intestinal comorbidities,history of invasive procedures,premature birth or full-term SGA and congenital malformations.Most anti-infective therapies are effective.However,if the patient had septic shock,the prognosis is poor.

关 键 词：解鸟氨酸拉乌尔菌 败血症 婴儿 新生 

分 类 号：R722.131[医药卫生—儿科]