An Analysis Of Clinical Characteristics And Pathogens In171Cases With Neonatal Septicemia

Objective:To investigate the clinical features, dection rate of positive germi culture, common pathogenic bacteria and drug resistance of neonatal septicemia. Compare the risk factors, mobidities of local infections, consitution of pathogens complications between early onset sepeticemia (EONS) and late onset neonatal septicemia (LONS)Method:171cases newborns with neonatal septicemia from September2010to Augest2011were retrospectively studied.The common risk factors, clinical manifestations, mobidities of local infections, complications, etiologic characteristics were statistically analizied. Comparison were made on the risk factors, rates of local infection, and consititution of pathogens between EONS and LONS were compared.Results:Premature birth, low birth weight, amniotic fluid turbidity, fetal distress, postnatal asphyxia, and invasive ventilation are high risk factors for EONS. The manifestation of neonatal septicemia were usually atypical.Among the virable manifestations, poor vatality or lethargy (63.4%), jaundice (57.3%), poor appetite (41.5%) and fever (39.8%) were predominant ones.The most common local infections accompanying nenatal sepeticemia were respiratory infections (91.2%), followed by infections of skin or mucosa membranes (28.1%). The incedence of infections of skin and mucosa infections were significantly different between EONS and LONS has statistically significant difference (P<0.05).99.4%of the cases were compared with other diseases, of which pathologic jaundice(49.1%)was the most common one.Among the171newborns with septicemia, the detection rate for positive germiculture is49.1%.In the newborns with positive germicultures,74.1%were gram positive bacteria, of which55.3%was CONS and44.9%of which was MRS. The detection rate for gram negative bacteria was23.5%,11.8%of which were gram negative bacteria with ESBLs.Fungi accounted for2.4%. There was statistically significant difference in the detection rate for gram positive bacteria infections between EONS and LONS (P<0.05). The sensitivity of penicillins, erythrocin, cefoxitin, oxacillin and SMZco to staphylococcus was low, while vancomycin was completely sensitive to grampositive coccus.Penicillin, firstgeneration cephalosporins, azotreonam had low sensitivity to gramnegative bac-teria. There was a downward trendency in sensitivity of third generation cephalosporin to gramnegative bacteria. Amikacin had high sensitivity to both gram positive and negative bacteria, including the bacteria with ESBLs.Conclusion:Premature birth, low birth weight, amniotic fluid turbidity, fetal distress, postnatal asphyxia, invasive ventilation were high risk factors for EONS. Neonatal sepeticemia were off en accompanied with local infections and other complications. The locations of infections between EONS and LONS were statistically different. The detection rate for positive germicultures was high in our department. And most of the pathogenic bacteria were grampositivetive bacteria. Even the oppotunistic pathogens such as CONS were the main pathogenic bacteria.Penicillins, erythrocin, firstgeneration cephalosporins, cefoxitin, oxacillin, aztreonam and SMZco was obviously not the fist choice for neonatal sepeticemia, for their drug-resistance were too high.