新生儿病理性黄疸60例血培养的结果与分析

目的了解咸阳地区目前新生儿病理性黄疸血培养的阳性率及早期确诊败血症,以便制定相应对策,合理选择有效抗生素。方法对2006年3月至2007年3月住院的60例病理性黄疸患儿的临床资料进行回顾性分析。结果本组60例血培养中阳性15例,占25%,其中金黄色葡萄球菌9例、表皮葡萄球菌4例、溶血葡萄球菌2例。本组葡萄球菌属的敏感药物主要为第3代头孢类、万古霉素及氨基糖甙类。对青霉素类、大环内酯类大多数耐药。60例患儿中,治愈57例、好转自动出院2例、1例放弃治疗死亡。结论血培养结果显示新生儿病理性黄疸中,因败血症所致占较大比例,特别是日龄较大的患儿应常规行血培养。该组血培养葡萄球菌感染占绝对优势,为以后儿科临床抗生素选择提供了一定的依据,提出不应单纯强调白细胞计数及分类作为败血症诊断思路的观点。

An analysis of results of blood culture of 60 neonates with pathological jaundice

Objective To investigate positive rate of blood culture among neonates with pathological jaundice in Xianyang city,Shaanxi province and to diagnose neonatal septicemia early,so as to working out corresponding measures to rationally choose effective antibiotics.Methods The clinical data of 60 neonates with pathological jaundice admitted to our hospital from March 2006 to March 2007 were reviewed.Results The results of blood culture of 15 neonates with pathological jaundice were positive and the positive rate was 25%,including 9 cases of Staphylococcus aureus,4 cases of Staphylococcus epidermidis,2 cases of Staphylococcus hemolyticus.In this group,the medicines sensitive to Staphylococcus mainly were the third generation of cephalosporins,vancomucin(VCM) and aminoglycosides.Penicillins and macrolides were resisted by the bacteria.57 of 60 nenates cured,2 neonates were improved and discharged without permission of the doctor and 1 neonate died.Conclusion The blood culture results in this study shows that the neonates with pathological jaundice caused by septicemia account for majority of the total.For these neonates,especially those older neonates,blood cultrue should be as a routine examination.Also,the blood culture results in this study shows that Staphylococcus infection is absolutely prominent,which provides a basis for choosing antibiotics in clinic and corrects the old viewpoint that only regards WBC and DC as diagnostic standard of septicemia.