CAJ | 학술논문

目的：总结分析新生儿社区获得性败血症晚发型的临床表现、主要致病菌分布及耐药性。方法回顾性分析2009年1月至2012年12月本院收治的122例（早产41例，足月81例）临床诊断为新生儿社区获得性败血症晚发型患儿的临床资料，进行统计分析。结果新生儿社区获得性败血症晚发型的主要临床表现为反应差（64．7％）、拒乳（57．4％）、体温变化（61．5％）。感染途径以呼吸道、脐部为主。122例共检出病原菌42例，血培养阳性率为34．4％，检出率在早产儿组和足月儿组间比较差异无统计学意义（ P＞0．05），其中葡萄球菌29例，包括金黄色葡萄球菌10例，凝固酶阴性葡萄球菌14例，肠球菌5例；大肠埃希菌10例。检出的球菌对青霉素、红霉素均耐药，对万古霉素、替考拉宁、利奈唑胺敏感。大肠埃希菌中对阿米卡星、亚胺培南、美罗培南敏感，对头孢唑林、头孢曲松、头孢他啶、头孢哌酮、呋喃妥因也有较高的敏感性。结论新生儿社区获得性败血症晚发型血培养阳性率不高，临床表现无特异性。病原菌主要为凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌。
목적：총결분석신생인사구획득성패혈증만발형적림상표현、주요치병균분포급내약성。방법회고성분석2009년1월지2012년12월본원수치적122례（조산41례，족월81례）림상진단위신생인사구획득성패혈증만발형환인적림상자료，진행통계분석。결과신생인사구획득성패혈증만발형적주요림상표현위반응차（64．7％）、거유（57．4％）、체온변화（61．5％）。감염도경이호흡도、제부위주。122례공검출병원균42례，혈배양양성솔위34．4％，검출솔재조산인조화족월인조간비교차이무통계학의의（ P＞0．05），기중포도구균29례，포괄금황색포도구균10례，응고매음성포도구균14례，장구균5례；대장애희균10례。검출적구균대청매소、홍매소균내약，대만고매소、체고랍저、리내서알민감。대장애희균중대아미잡성、아알배남、미라배남민감，대두포서림、두포곡송、두포타정、두포고동、부남타인야유교고적민감성。결론신생인사구획득성패혈증만발형혈배양양성솔불고，림상표현무특이성。병원균주요위응고매음성포도구균、금황색포도구균、대장애희균。
Objective To summarize the clinical manifestation ,the main pathogenic bacteria distribution and drug resistance of neonatal community acquired sepsis late onset in our hospital .Methods Retrospectively analyse the clinical material of 122 cases (41 premature cases and 81 cases of full term) with neonatal community acquired sepsis late onset ,which were clinically diagnosed , from January 2009 to December 2012 in our hospital .Results The main clinical manifestation of neonatal community acquired sep-sis late onset was poor response(64 .7% ) ,repellent milk(57 .4% ) ,temperature changes(61 .5% ) ,and the respiratory tract and um-bilical region were the main infection ways .42 cases were checked out with pathogen in the 122 cases ,blood culture positive rate was 34 .4% ,and there was no statistically differences between the premature and the full term infant group ,In the 42 cases ,there were 29 cases with staphylococcus ,including 10 cases of staphylococcus aureus ,14 cases of coagulase negative staphylococcus and 5 cases of enterococcus ;and there were 10 cases are checked out with e .coli .All of the coccus detected were resistant to penicillin and erythromycin ,but sensitive to vancomycin ,teicoplanin ,linezolid .The e .coli was sensitive to amikacin ,imipenem ,meropenem ,and al-so had a higher sensitivity to cefazolin ,ceftriaxone ,cefepime ,cefoperazone and nitrofurantoin .Conclusion Blood culture positive rate is not high in neonatal community acquired sepsis late onset ,and its′clinical manifestations are nonspecific .The main pathogenic bacteria is coagulase negative staphylococcus ,staphylococcus aureus ,followed by escherichia coli .