摘要
目的:分析探讨不同类型新生儿败血症的临床、病原菌特点及生化指标差异。方法:选取本院2021年1月到2023年12月收治的血培养阳性的新生儿败血症患儿60例,将早发型新生儿败血症(Early onset neonatal sepsis,EONS)患儿30例纳入A组,晚发型新生儿败血症(Late onset neonatal sepsis,LONS)患儿30例纳入B组。收集并比较两组临床表现、病原菌分布、耐药性以及生化指标差异。结果:A组中,胎龄<37 w、出生体质量<2.5 kg、发热占比均低于B组(P<0.05);A组患儿新生儿窒息、羊水污染、黄疸、奶潴留发生率均高于B组(P<0.05)。A组病原菌以革兰阳性菌为主,对万古霉素、替考拉宁敏感度最高;B组患儿病原菌以革兰阴性菌为主,对亚胺培南、美罗培南敏感度最高。A组血小板计数(Platelet,PLT)低于B组(P<0.05);A组平均血小板体积(Mean platelet volume,MPV)高于B组(P<0.05)。结论:不同类型新生儿败血症患儿临床表现、病原菌分布、生化指标存在一定差异,临床应注意鉴别诊断,并根据药敏结果选择抗生素治疗,避免抗生素滥用。
Objective:To analyze and explore the clinical,pathogenic characteristics,and biochemical differences of different types of neonatal sepsis.Methods:Sixty cases of neonatal sepsis patients with positive blood culture admitted to our hospital from January 2021 to December 2023 were selected.Thirty cases of early onset neonatal sepsis(EONS)were included in Group A,and thirty cases of late onset neonatal sepsis(LONS)were included in Group B.The clinical manifestations,pathogen distribution,drug resistance,and biochemical indicators were collected and compared between two groups.Results:The proportion of gestational age<37 weeks,birth weight<2.5 kg,and fever incidence in Group A were lower than those in Group B(P<0.05);The incidence of neonatal asphyxia,amniotic fluid pollution,jaundice and milk retention in group A were higher than those in group B(P<0.05).The pathogenic bacteria in Group A are mainly Gram positive bacteria,with the highest sensitivity to vancomycin and teicoplanin;The pathogenic bacteria in Group B are mainly Gram negative bacteria,with the highest sensitivity to imipenem and meropenem.The PLT of Group A was lower than that of Group B(P<0.05);The MPV of Group A was higher than that of Group B(P<0.05).Conclusion:There are certain differences in clinical manifestations,pathogen distribution,and biochemical indicators among children with different types of neonatal sepsis.Clinical attention should be paid to differential diagnosis,and antibiotic treatment should be selected based on drug sensitivity results,to avoid antibiotic abuse.
作者
胡欣慧
曹程辉
刘振民
Hu Xin-hui;Cao Cheng-hui;Liu Zhen-min(Department of Neonatology,Ningdu People's Hospital,Ganzhou 342800,Jiangxi,China)
