Clinical Analysis Of 122 Cases Of Neonatal Sepsis

Objective: The purpose of the study was to investigate 122 cases of neonatal sepsis,which these cases from from 2011 to 2016,in general situation,clinical features,laboratory tests,pathogenic bacteria distribution and drug sensitivity results in order to provide important help for clinical workMethods: The clinical retrospective study was done.The definition of early-onset sepsis(the onset time was less than 72 hours after birth),late-onset sepsis(the onset time was after 72 hours after birth).Collecting clinical data of 122 neonates with septicemia and analysis the general situation,clinical features,laboratory tests and pathogenic bacteria distribution of two groups,and the changes of pathogenic bacteria and drug sensitivity in the past 6 years.Result: 1.122 cases of neonatal sepsis,including 39 cases early-onset sepsis,82 cases late-onset sepsis.There were significant differences in perinatal risk factors of premature membrane,amniotic fluid pollution,birth asphyxia,maternal prenatal infection in the two groups(?2=9.290?4.993?11.456?6.546,P<0.05).2.Neonatal sepsis have a variety of clinical manifestations.The two groups in the convulsion,skin infection,omphalitis have statistical difference(?2=9.218?10.297,P<0.05)3.In this study,68 cases of pulmonary infection accounted for 55.7%,the highest proportion,followed by a diffuse intravascular coagulation disorder of 57 cases accounted for 46.7%,early and late onset group was statistically difference between meningitis(?2=5.600,P<0.05).4.74 cases of children with elevated C reactive protein accounted for 60.7%,31 cases of children with Abnormal white blood cell count accounted for 25.4%,26 cases of The platelet count decreased accounted for 21.3%.There was no significant difference between the early and late onset group in the three groups.5.In this study,82 cases were improved,accounting for 67.2% of the cases,and the number of patients who gave up or died was 40 accounting for 32.8%.There was no statistical difference between the two groups.6.Results of 122 cases of blood culture,gram-positive bacteria 81 cases accounted for 66.4%,gram-negative bacteria 36 accounted for 29.5%,fungus,5 cases of the total accounted for4.1%,There was no significant difference between the early and late onset group in the three group.Gram-positive bacteria was the main type of early onset sepsis,coagulase-negative staphylococci19 accounted for 48.7%,11 cases Staphylococcus epidermidis accounted for 28.2%,6 cases Escherichia coli accounted for 15.4%,5 cases Staphylococcus aureus accounted for12.8%,1 case Fungi accounted for 2.5%,gram-negative bacteria was the main type of late-onset sepsis,coagulase-negative staphylococci 44 accounted for 53.0%,24 cases Staphylococcus epidermidis accounted for 28.9%,13 cases Staphylococcus aureus accounted for15.6%,11 cases of Klebsiella pneumoniae accounted for 13.2%,4case Fungi accounted for 4.8%.2011-2013,the detection rate of gram-positive bacteria was 76.9%,the detection rate of gram-negative bacteria was about 17.3%,2014-2016,the detection rate of gram-positive bacteria was 58.6%,the detection rate of gram-negative bacteria was about 38.6% and there was a significant difference between gram-positive bacteria and gram-positive bacteria in 3 years before and after(?2=4.530?6.485,P<0.05).7.Coagulase negative Staphylococcus to penicillin,ampicillin,oxacillin,cefazolin,ceftriaxone,amoxicillin,ampicillin sulbactam,like erythromycin resistance rate more than 80%,1cases of vancomycin resistant Staphylococcus aureus was discovered in all gram-positive bacteria.Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae three together respectively to ampicillin,piperacillin,cefazolin,cefuroxime and ceftazidime resistance,ceftriaxone,cefotaxime,cefepime rate was more than 75% and the drug resistance of beta lactamase inhibitors was low,It was not found that gram-negative bacteria was resistant to carbapenems.The drug resistance of Candida albicans and Candida albicans were not found.Conclusion:1.There are some differences in perinatal factors,clinical features,complications and pathogens between neonatal early-onset sepsis and late-onset sepsis.2.Gram positive bacteria was mainly in neonatal sepsis,both early onset and late onset sepsis,coagulase negative staphylococci were the main pathogenic bacteria,which the major bacteria is steaphylococcus epidermidis.Gram negative bacteria were mainly Klebsiella pneumoniae and Escherichia coli,which early onset sepsis was mainly caused by Klebsiella pneumoniae and Escherichia coli and late-onset sepsis.The detection rate of gram positive bacteria was decreased in recent years,and the detection rate of gram negative bacteria increased,but gram positive bacteria were the main ones.3.Gram positive bacteria and gram negative bacteria were highly resistant to penicillin and cephalosporin antibiotics,The use of antibiotics should be based on the local bacterial spectrum and drug sensitivity.