疑似新生儿败血症的细菌学特征及其与选定危险因素的关系

Q4 Medicine
Md. Shamsul Alam, Sanaul Haque Mia, Md. Belal Uddin
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引用次数: 2

摘要

新生儿败血症是新生儿的主要问题之一,病死率高。新生儿败血症的表现是微妙的和非特异性的。血培养是诊断新生儿败血症的“金标准”,有或没有实验室感染证据的高怀疑指数是早期诊断的关键。早期诊断和应用抗生素可降低死亡率和发病率。目的:探讨疑似新生儿败血症的菌群及其与危险因素的关系。材料与方法:对2008年7月至2010年6月Rajshahi医学院附属医院儿科病房收治的所有疑似新生儿败血症病例进行横断面描述性研究,共纳入6060例无特异性败血症症状的患者。在临床评估和管理患者血液培养后,对所有有脓毒症危险因素或体征的新生儿进行了检查。结果:60例疑似新生儿败血症患儿中,18.33%细菌培养阳性。革兰氏阴性菌和革兰氏阳性菌都是导致新生儿败血症的原因。革兰氏阴性菌最多(54.5%),最常见的是大肠杆菌(54.5%),其他革兰氏阳性菌分别为链球菌(27.3%)和金黄色葡萄球菌(18.2%)。在血培养阳性病例中,82%为早发型新生儿败血症,18%为晚发型败血症。胎龄、低出生体重、母亲低社会经济地位、分娩方式和出生窒息是早发型新生儿败血症和晚发型新生儿败血症的危险因素。结论:败血症是导致死亡的主要原因之一,其表现不明显,不具有特异性。革兰氏阴性菌和革兰氏阳性菌都是导致新生儿败血症的原因。大多数分离的细菌大肠杆菌。风险因素可能是神经性麻痹的因素。虽然血培养是NNS诊断的“金标准”,但有或没有实验室感染证据的高怀疑指数是早期诊断的关键。如果我们能通过对孕妇的产前检查,避免NNS的危险因素,从而减少败血症的数量。今日医学2022 Vol.34(1): 17-21
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bacteriological Profile of Suspected Neonatal Septicaemia and Its Relationship with Selected Risk Factors
Introduction: Neonatal septicaemia is one of the major problem in neonatology with a high case fatality rate. Manifestations of neonatal septicaemia are subtle & non-specific. Blood culture is the “gold standard” in the diagnosis of neonatal septicaemia, a high index of suspicion with or without laboratory evidences of infection is the key for early diagnosis. Early diagnosis & introduction of antibiotic may reduce mortality and morbidity. Objective: To explore the bacterial organisms among the suspected neonatal septicaemic cases and its relationship with selected risk factors. Materials and Methods: A Cross sectional descriptive type of study was carried out on all suspected cases of neonatal septicaemia patients admitted in the paediatric wards of Rajshahi Medical College Hospital during the period of july 2008 to june 2010 .Total 60 sixty cases who had non- specific symptoms of septicaemia were enrolled in this study. After a clinical evaluation and management of the patient blood culture was performed on all neonates with risk factors or signs suggestive of sepsis. Results: Out of sixty cases of suspected neonatal septiceamic newborns 18.33% were culture positive for bacteria. Both gram negative and gram positive bacteria were responsible for neonatal septicaemia. Majority of the organisms were gram negative (54.5%) and most common organisms was E.coli (54.5%) .Other gram-positive organisms were streptococcus spp(27.3%) and staph aureus(18.2%) respectively. Among blood culture positive cases 82% were early onset neonatal septicaemia & 18% were late onset septisaemia. Gestational age, Low birth weight, Low socioeconomic status of mother, mode of delivery and birth asphyxia were risk factor for both early onset neonatal sepsis & late onset neonatal sepsis. Conclusion: Septicaemia is one of the major causes of death & its manifestations are subtle and non specific. Both gram negative & gram positive bacteria are responsible for neonatal septicaemia. Most isolated bacteria E.coli. Risk factors may be the factor for NNS. Although blood culture is the “gold standard” in the diagnosis of NNS, a high index of suspicion with or without laboratory evidences of infection is the key for early diagnosis. If we can avoid risk factors for NNS by antenatal check up of pregnant mother and thereby number of septicaemia could be reduced. Medicine Today 2022 Vol.34(1): 17-21
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Medicine Today
Medicine Today Medicine-Medicine (all)
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