摘要
目的分析不同病原菌感染早产儿败血症的临床特点、血液学指标及临床结局。方法依据感染病原菌不同将商丘市第一人民医院90例早产儿败血症患儿分为革兰阳性菌组、革兰阴性菌组、真菌组,分析各组患儿临床特点、炎症指标[白细胞计数(WBC)、血小板(PLT)、C-反应蛋白(CRP)]及临床结局。结果90例早产儿败血症患儿根据检出病原菌分为革兰阳性菌组26例、革兰阴性菌组42例、真菌组22例;革兰阳性菌以表皮葡萄球菌为主,革兰阴性菌以肺炎克雷伯菌、大肠埃希菌为主,真菌以近平滑假丝酵母、白假丝酵母为主。真菌组出生体质量最低、胎龄最小(P<0.05),革兰阳性菌组、革兰阴性菌组早发型比例较高(P<0.05)。革兰阳性菌组和革兰阴性菌组首发症状中呼吸困难占比高于真菌组,腹胀占比低于真菌组(P<0.05),革兰阳性菌组血培养转阴时间最短(P<0.05),三组发病时WBC和PLT异常率比较差异有统计学意义(P<0.05)。革兰阴性菌组感染前机械通气时间最长(P<0.05),真菌组感染前抗生素使用时间、深静脉置管留置时间最长(P<0.05),真菌组住院时间、住院费用最高(P<0.05);革兰阴性菌组肺炎、支气管肺发育不良发生率最高,革兰阴性菌组、真菌组坏死性小肠炎发生率高于革兰阳性菌组(P<0.05);革兰阴性菌组治愈或好转出院率最低(P<0.05)。结论不同病原菌感染致早产儿败血症临床特点不尽相同,需结合临床症状、发病日龄及血液学指标等综合判断,并及早合理用药。
OBJECTIVE To analyze the clinical characteristics,hematological indexes and clinical outcomes of the premature infants with sepsis induced by different pathogens.METHODS A total of 90premature infants with sepsis who were treated in Shangqiu First People′s Hospital were divided into the gram-positive bacteria group,the gram-negative bacteria group and the fungi group according to the pathogens.The clinical characteristics,inflammatory indexes[white blood cell(WBC),platelet(PLT),C-reactive protein(CRP)]and clinical outcomes of the infants were observed.RESULTS The 90premature infants with sepsis were divided into the gram-positive bacteria group with 26cases,the gram-negative bacteria group with 42cases and the fungi group with 22cases according to the isolated pathogens.Staphylococcus epidermidis was the predominant species of gram-positive bacteria;Klebsiella pneumoniae and Escherichia coli were dominant among the gram-negative bacteria;Candida parapsilosis and Candida albicans were dominant among the fungi.The birth weight was the lowest and the gestational age was significantly least in the fungi group(P<0.05),the proportion of early-onset type was significantly higher in the gram-positive bacteria group and the gram-negative bacteria group(P<0.05).The proportion of the infants with dyspnea as the initial symptom was significantly higher in the gram-positive bacteria group and the gram-negative bacteria group than in the fungi group,and the proportion of the infants with abdominal distension was higher in the fungi group(P<0.05).The negative conversion time of blood culture of the gram-positive bacteria group was the shortest(P<0.05);there were significant differences in the abnormal rates of WBC and PLT among the three groups at the onset of disease(P<0.05).The mechanical ventilation duration of the gram-negative bacteria group was the longest before the infection(P<0.05);the time of use of antibiotics and deep venous catheter indwelling time of the fungi group were the longest before the infection(P<0.05);
作者
刘雨露
王战胜
邵民坤
段道云
施雪颖
王栋
LIU Yu-lu;WANG Zhan-sheng;SHAO Min-kun;DUAN Dao-yun;SHI Xue-ying;WANG Dong(Shangqiu First People′s Hospital,Shangqiu,Henan 476100,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第17期2712-2716,共5页
Chinese Journal of Nosocomiology
基金
河南省科研基金资助项目(201912111)。
关键词
革兰阳性菌
革兰阴性菌
真菌
早产儿败血症
临床特点
血液学指标
临床结局
Gram-positive bacteria
Gram-negative bacteria
Fungi
Premature infant with sepsis
Clinical characteristic
Hematological index
Clinical outcome
