新生儿败血症的危险因素和微生物预后:一项临床研究

Venugopal Reddy I
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摘要

感染是全世界新生儿死亡的主要原因。每年新生儿死亡(30-50%)是由败血症造成的。由于医院感染及其相关的发病率、费用和死亡率,改善新生儿结局是复杂的,因为发展中国家的医院面临感染传播的重大风险。本研究旨在分析新生儿重症监护室和产后病房脓毒症的危险因素和微生物学结果。这项研究尽可能早地诊断出受影响的新生儿,以便在不增加抗生素耐药性负担的情况下进行适当的抗生素治疗。在这项研究中,94%患有新生儿败血症的婴儿出院,6%的婴儿死于疾病。1500-2500克的低出生体重被认为是导致婴儿败血症的重要因素。在46%的病例中,早破时间大于18小时。肺炎克雷伯菌是本研究革兰氏阴性菌中常见的致病菌,是导致新生儿败血症的常见原因;凝固酶阴性葡萄球菌和金黄色葡萄球菌是革兰氏阳性菌中常见的细菌。观察到晚发性脓毒症的死亡率较高,这可能是由于延长新生儿重症监护病房的住院时间、机械通气、脐静脉置管和中心静脉导管等多种干预措施所致。
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Risk Factors and Microbiological Outcome in Neonatal Sepsis: A Clinical Study
Infection is the predominant cause of neonatal deaths universally. Neonatal deaths (30-50%) every year is caused due to sepsis. Due to nosocomial infections and their associated morbidities, cost and mortality, betterment of neonatal outcomes is complicated as hospitals in developing countries are at major risk for the transmission of infection. The present study aimed to analyse sepsis risk factors and microbiological outcome in the NICU and post-natal ward. The study diagnosed the affected neonates as earliest possible so that suitable antibiotic treatment can be done without adding to the burden of antibiotic resistance. In this study, 94% of babies with neonatal sepsis were discharged and 6% of babies succumbed to the illness. Low birth weight between 1500-2500 grams was noted as an important contributing factor to sepsis in babies. PROM was found to be greater than 18 hours in (46%) of cases. Klebsiella pneumoniae was the common pathogen amongst gram negative bacteria in the present study and thus was the common cause of septicemia in neonates, and Coagulase negative Staphylococcus and Staphylococcus aureus were common bacteria among the gram-positive bacteria. A higher mortality rate in cases of late onset sepsis was observed and was explained probably due to prolonged NICU stay, multiple interventions such as mechanical ventilation, umbilical venous catheterization, and central lines.
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