摘要
目的 观察早发型新生儿败血症(EONS)感染病原菌特点,并分析外周血颗粒蛋白前体(PGRN)、胰石蛋白(PSP)、降钙素原(PCT)的诊断价值。方法 选取柘城县中医院114例EONS新生儿(研究组)及同期100例无感染新生儿(对照组),检测败血症新生儿病原菌分布及耐药性,测定两组外周血PGRN、PSP、PCT表达水平,采用Logistic回归模型分析检测指标与EONS的关系,并以受试者工作特征(ROC)曲线分析其对EONS感染诊断价值。结果 EONS感染主要为革兰阴性菌,其中又以大肠埃希菌(42.11%)与肺炎克雷伯菌(26.32%)为主,革兰阳性菌以凝固酶阴性葡萄球菌(10.53%)与表皮葡萄球菌(7.02%)为主;大肠埃希菌与肺炎克雷伯菌对青霉素、氨苄西林、苯唑西林、阿莫西林/克拉维酸、头孢呋辛等具有较高耐药性;表皮葡萄球菌对青霉素、红霉素、苯唑西林、阿莫西林/克拉维酸、哌拉西林/他唑巴坦具有较高耐药性,凝固酶阴性葡萄球菌对青霉素、氨苄西林、红霉素具有较高耐药性;研究组外周血PGRN、PSP、PCT水平高于对照组(P<0.05),外周血PCT、PGRN、PSP和EONS的发生有关(P<0.05),外周血PGRN、PSP、PCT联合诊断敏感度94.16%,特异度70.28%。结论 EONS感染以革兰阴性菌为主,具有多重耐药特征,外周血PCT、PGRN与PSP联合检测对EONS具有较高诊断效能。
OBJECTIVE To observe pathogenic bacteria characteristics of early-onset neonatal sepsis(EONS) infection, and analyze the diagnostic value of peripheral blood pregranulin(PGRN), pancreatic stone protein(PSP) and procalcitonin(PCT). METHODS Total of 114 neonates with EONS(in the observation group) and 100 uninfected neonates(in the control group) in Zhecheng Hospital of Traditional Chinese Medicine were recruited. The distribution and drug resistance of pathogenic bacteria in neonates with sepsis were tested. The expression levels of peripheral blood PGRN, PSP and PCT between the two groups were detected. Multivariate Logistic regression model was used to analyze the relationship between the detected indicators and EONS. The receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of these indicators in EONS infection. RESULTS EONS infections were mainly caused by Gram-negative bacteria which was dominated by Escherichia coli(42.11%) and Klebsiella pneumoniae(26.32%). Gram-positive bacteria mainly included coagulase-negative Staphylococcus(10.53%) and Staphylococcus epidermidis(7.02%). E. coli and K. pneumoniae were highly resistant to penicillin, ampicillin, oxacillin, amoxicillin/clavulanic acid, and cefuroxime. S. epidermidis was highly resistant to penicillin, erythromycin, oxacillin, amoxicillin/clavulanic acid, and piperacillin/tazobactam. Coagulase-negative Staphylococci was highly resistant to penicillin, ampicillin, and erythromycin. Peripheral blood levels of PGRN, PSP and PCT in the observation group were significantly higher than those in the control group(P<0.05). Peripheral blood PCT, PGRN and PSP levels were related to the occurrence of EONS(P<0.05). The sensitivity and specificity of the combination of peripheral blood PGRN, PSP and PCT in diagnosis were 94.16% and 70.28%, respectively. CONCLUSION EONS infection is mainly caused by Gram-negative bacteria with multi-drug resistance. The combined detection of peripheral blood PCT, PGRN and PSP has high diagnostic efficiency for EONS.
作者
高红丽
黄兰英
刘文源
张建芳
李占峰
GAO Hong-li;HUANG Lan-ying;LIU Wen-yuan;ZHANG Jian-fang;LI Zhan-feng(Zhecheng Hospital of Traditional ChineseMedicine,Shangqiu,Henan 476000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第9期1392-1396,共5页
Chinese Journal of Nosocomiology
基金
商丘市科技发展计划基金资助项目(2019118)。
关键词
早发型
新生儿败血症
病原菌
颗粒蛋白前体
胰石蛋白
降钙素原
Early onset
Neonatal sepsis
Pathogenic bacteria
Pregranulin
Pancreatic stone protein
Procalcitonin
