新生儿粘质沙雷菌败血症8例临床分析

目的 探讨新生儿粘质沙雷菌败血症发生的危险因素、临床特点、药敏情况。方法对在本院新生儿重症监护病房(NICU)住院的8例粘质沙雷菌感染新生儿的危险因素、临床特点、药敏情况等临床资料进行分析。结果8例患儿胎龄为28～30.3周,出生体重为800～1 552 g,所有对象均有经外周中心静脉置管(PICC)等侵袭性操作史,主要临床表现有呼吸暂停、腹胀、黄疸、发热等,外周血C反应蛋白(CRP)、降钙素原(PCT)显著增高,血小板计数(PLT)下降明显,脑脊液(CSF)检查证实7例合并颅内感染,1例因家属放弃治疗未完善脑脊液检查。粘质沙雷菌对氨基糖甙类及喹诺酮类抗生素敏感,对青霉素类、头孢菌素类及碳青霉烯类抗生素均耐药。最终治愈7例,死亡1例。结论粘质沙雷菌作为一种条件致病菌,易发生院内严重新生儿感染,并发颅内感染几率高。对常用抗生素及碳青霉烯类抗生素耐药,对氨基糖甙类及喹诺酮类抗生素敏感。

Clinical analysis of eight cases of serratia marcescens sepsis in neonates

Objective To study the risk factors,clinical characteristics of neonatal sepsis caused Serratia marcescens and the antibiotic sensitivity pattern of Serratia marcescens stains.MethodThe risk factors,clinical characteristics and antibiotic sensitivity pattern of 8 cases of neonatal sepsis caused by Serratia marcescens in the neonatal intensive care unit (NICU) were retrospectively studied.Results8 cases of neonatal sepsis had invasive intervention,such as peripherally inserted central catheter (PICC),whose gestational age was between 28 and 32 weeks,birth weight was between 800g and 1552g. The clinical presentatiaons including apnea,abdominal distensionjaundice,fever,increased C-reaction protein (CRP) level and procalcitonin (PCT) level were increased,platelet (PLT)declined in all of the cases,7 had meningitis confirmed by cerebrospinal-fluid (CSF) test,who were cured in the end. The Serratia marcescensare strains were sensitive to aminoglycoside and quinolones antibiotics,resistant to penicillins,cephalosporins and carbapenem antibiotics.One case hadn''t conducted cerebrospinal-fluid (CSF) test for giving up treatment and died.ConclusionThe Serratia marcescensare is the major conditional pathogenic bacterium during hospital infections and high incidence of purulent meningitis. The Serratia marcescensare strains were sensitive to aminoglycoside and quinolones antibiotics,resistant to penicillins,cephalosporins and carbapenem antibiotics.