背景:无乳链球菌(GBS)和大肠杆菌(E.大肠杆菌)是新生儿败血症的主要致病菌。因此,临床特征,非特异性指标,并研究了这两种细菌的药物敏感性。
方法:总共,81和80例儿童由GBS和大肠杆菌感染引起的败血症,分别,2012年5月至2023年7月我院新生儿科收治,入选,分析两组患者的临床特点。回顾性分析非特异性指标及药敏试验结果。
结果:出生体重,呼吸急促,呻吟,心动过速或心动过缓,以及并发症的发生率,比如肺炎,呼吸衰竭,化脓性脑膜炎,GBS组高于大肠杆菌组。孩子们过早出生,母亲胎膜早破.黄疸的发生率,腹胀,不典型的临床表现,坏死性小肠结肠炎的并发症低于大肠杆菌组,差异均有统计学意义(p<0.05)。WBC,NE#,NE#/LY#,hs-CRP,GBS组PCT高于大肠杆菌组,而MPV,D-D,FDP水平低于大肠杆菌组。差异均有统计学意义(p<0.05)。81珠GBS对四环素有很高的耐药率(95%),红霉素(48.8%),和克林霉素(40%),没有对万古霉素耐药的菌株,利奈唑胺,青霉素,或者氨苄青霉素出现了,而80株大肠杆菌对青霉素和第三代头孢菌素的耐药性更强,氨苄青霉素耐药率较高(68.30%),甲氧苄啶/磺胺甲恶唑(53.6%),环丙沙星(42.90%)。对碳青霉烯类和氨基糖苷类的耐药率极低。
结论:GBS和E.coli新生儿败血症均具有特定的临床特征,特别是在临床表现方面,并发症,非特定指标,和抗药性。早期识别对临床诊断和治疗具有重要意义。
BACKGROUND: Streptococcus agalactiae (GBS) and Escherichia coli (E. coli) are the main pathogenic bacteria in neonatal sepsis. Therefore, the clinical characteristics, nonspecific indicators, and drug susceptibilities of these two bacteria were studied.
METHODS: In total, 81 and 80 children with sepsis caused by GBS and E. coli infection, respectively, admitted to the neonatal department of our hospital between May 2012 and July 2023, were selected, and the clinical characteris-tics of the two groups were analyzed. Nonspecific indicators and drug sensitivity test results were analyzed retrospectively.
RESULTS: Birth weight, tachypnea, groan, tachycardia or bradycardia, and the incidence of complications, such as pneumonia, respiratory failure, and purulent meningitis, were higher in the GBS group than in the E. coli group. The children were born prematurely, and the mother had a premature rupture of membranes. The incidence of jaundice, abdominal distension, atypical clinical manifestations, and complications of necrotizing enterocolitis was lower than of the E. coli group, and the differences were statistically significant (p < 0.05). The WBC, NE#, NE#/LY#, hs-CRP, and PCT of the GBS group were higher than those of the E. coli group, whereas the MPV, D-D, and FDP levels were lower than those in the E. coli group. The differences were all statistically significant (p < 0.05). The 81-bead GBS had high resistance rates against tetracycline (95%), erythromycin (48.8%), and clindamycin (40%), and no strains resistant to vancomycin, linezolid, penicillin, or ampicillin appeared, whereas 80 strains of E. coli were more resistant to penicillin and third-generation cephalosporins, with the higher resistance rates to ampicillin (68.30%), trimethoprim/sulfamethoxazole (53.6%), and ciprofloxacin (42.90%). Resistance rates to carbapenems and aminoglycosides were extremely low.
CONCLUSIONS: Both GBS and E. coli neonatal sepsis have specific clinical characteristics, especially in terms of clinical manifestations, complications, non-specific indicators, and drug resistance. Early identification is important for clinical diagnosis and treatment.