| 社区与院内感染新生儿败血症晚发型的临床特点对比分析 |
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| 引用本文： | 周启立1,王丽君2,孙鹏1,武彦秋1,王燕1,刘霞1. 社区与院内感染新生儿败血症晚发型的临床特点对比分析[J]. 现代预防医学, 2015, 0(15): 2744-2746 |
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| 作者姓名： | 周启立1 王丽君2 孙鹏1 武彦秋1 王燕1 刘霞1 |
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| 作者单位： | 1.承德医学院附属医院小儿内科，河北 承德 067000；2.承德护理职业学院，河北 承德067000 |
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| 摘 要： | 摘要:目的 对比分析社区感染与院内感染所致新生儿败血症晚发型（Late-Onset Sepsis，LOS）的临床特点、病原菌分布及药敏情况，为临床早期合理诊治提供依据。方法 选择某院2009年1月至2013年12月收治的168例新生儿败血症晚发型的临床资料，按照发生地点分为社区感染病例123例，院内感染病例45例，进行对比统计分析。结果 低体温、黄疸在社区感染组多见；腹胀、呼吸暂停在院内感染组多见；两组非特异性指标改变无差异；血培养阳性率及病原菌构成无差异；主要病原菌为凝固酶阴性葡萄球菌（CONS）21例（35.0%），大肠埃希菌15例（25.0%），金黄色葡萄球菌11例（18.3%）；凝固酶阴性葡萄球菌对常用抗菌药物的耐药率较高，对万古霉素敏感，对比两组无统计学差异；社区感染组大肠埃希菌对头孢唑林、头孢他啶、头孢曲松和头孢哌酮的耐药率明显低于院内感染组，对亚胺培南、美罗培南敏感。结论 社区感染与院内感染新生儿败血症晚发型在临床表现、非特异性指标及病原菌分布及耐药率各有不同，临床应根据不同特点争取早期诊断、合理治疗。
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| 关 键 词： | 关键词:新生儿败血症 临床表现 病原菌 药敏 |
Comparative analysis on clinical characteristic of community-acquired and hospital-infected neonatal septicemia for late-onset |
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| ZHOU Qi-li,WANG Li-jun,SUN Peng,WU Yan-qiu,WANG Yan,LIU Xia. Comparative analysis on clinical characteristic of community-acquired and hospital-infected neonatal septicemia for late-onset[J]. Modern Preventive Medicine, 2015, 0(15): 2744-2746 |
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| Authors: | ZHOU Qi-li WANG Li-jun SUN Peng WU Yan-qiu WANG Yan LIU Xia |
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| Affiliation: | Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, China |
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| Abstract: | Abstract: Objective To take comparative analysis of the clinical characteristics, pathogens distribution and drug sensitive testing in neonatal septicemia for late-onset of community-infected and hospital-infected, and to provide evidence for early diagnosis and treatment. Methods 168 patients of hospital between January 2009 and December 2013 were included in this study. They were divided into two groups of 123 cases of community-acquired and 45 cases of hospital-infected. Results The clinical manifestation of hypothermia, jaundice were higher in community-acquired than hospital-infected, but abdominal distension, apnea were higher in hospital-infected than community-acquired. There were no statistical difference in the non-specificity index of the two groups. The positive culture test and composition of pathogen had no statistical difference. The common pathogen of coagulase-negative staphylococcus (CONS), E.coli and Staphylococcus were 21(35.0%), 15(25.0%) and 11(18.3%), respectively. The Coagulase- negative tstaphylococcus had a stronger drug resistance rate, but showed sensitivity to vancomycin, which had no statistical difference in the two groups. The drug resistance rate for E.coli in community-acquired group to cefazolin, ceftazidime, cefatriaxone, cefoperazone were lower than hospital-infected group, but showed sensitivity to imipenem and meropenem. Conclusion The clinical manifestation, non-specificity index, pathogens distribution and drug resistance rate in community- acquired and hospital-infected were different. Hence, early diagnosis and rational therapy should be based on the different clinical characteristic. |
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| Keywords: | Keywords: Neonate septicemia Clinical manifestation Pathogen Drug sensitive test |
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