早产低体重儿蜡样芽孢杆菌败血症3例报告并文献复习  

Septicemia caused by Bacillus cereus in premature low birth weight infants:3 cases report and literature review

作　　者：李沛[1] 赵心懋[1] 李蕊[2] 杨青 袁晓宁[1] 张会芝[1] 邢燕[1,2] LI Pei;ZHAO Xinmao;LI Rui;YANG Qing;YUAN Xiaoning;ZHANG Huizhi;XING Yan(Department of Healthcare-associated Infection Management,Peking University Third Hospital,Beijing 100191,China;Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院医院感染管理处,北京100191 [2]北京大学第三医院儿科,北京100191

出　　处：《中国感染控制杂志》2025年第2期258-263,共6页Chinese Journal of Infection Control

基　　金：国家重点研发计划项目(2021YFC2700700);首都卫生发展科研专项项目(首发2024-2G-40916);北京大学第三医院队列建设项目(BYSYDL2022008)。

摘　　要：目的总结低出生体重儿蜡样芽孢杆菌败血症病例特点和感染风险,为感染预防和控制提供参考。方法报告并分析3例低出生体重儿蜡样芽孢杆菌败血症病例特征,并系统检索相关文献总结新生儿蜡样芽孢杆菌败血症病例特点和医院感染风险来源。结果本文报告的3例早产低出生体重儿中2例死亡,1例治愈,经物体表面采样分析,未发现环境中明确的感染来源。总计检索到既往文献报告43例病例,41例有生存报道的病死率达36.6%,感染危险因素主要为辅助通气、脐静脉置管(UVC)或中心静脉置管及肠内喂养。在明确感染来源的3例报道中,致病菌分别来自亲母母乳、装修区域、暖箱表面和超声探头。结论早产低出生体重儿蜡样芽孢杆菌败血症病死率高、预后差,是严重威胁低出生体重儿生命健康的医院感染性疾病,新生儿重症监护病房和医院感染管理相关部门需要重视对该细菌所致医院感染的预防、监测以及早期发现和积极诊治。Objective To summarize the characteristics and sources of infection risk of Bacillus cereus(B.cereus)septicemia in low birth weight(LBW)infants,and provide reference for infection prevention and control.Methods Characteristics of 3 LBW infants with B.cereus septicemia were reported and analyzed,relevant literatures were searched for systematically summarizing the characteristics and sources of infection risk of B.cereus septicemia in infants.Results Among 3 LBW infants reported in this paper,2 died and 1 was cured.No clear infection source was found in the environment through object surface sampling analysis.A total of 43 cases were reported in the previous literatures,41 cases had reported on survival status,the mortality was 36.6%.The main risk factors for infection were auxiliary ventilation,umbilical vein catheterization or central vein catheterization and enteral feeding.In the reported 3 cases with clear sources of infection,the pathogens came from mother’s milk,decoration area,surface of infant incubator and ultrasonic probe.Conclusion Premature LBW infants with B.cereus septicemia have high mortality and poor prognosis,which is a healthcare-associated infectious disease seriously threatening the life and health of LBW infants.Neonatal intensive care unit(NICU)and relevant departments of healthcare-associated infection(HAI)management need to pay attention to the prevention,monitoring,early detection,as well as active diagnosis and treatment of HAI caused by this bacteria.

关 键 词：蜡样芽孢杆菌 败血症 低出生体重儿 医院感染 

分 类 号：R722.131[医药卫生—儿科]