A Clinical Study On The High Risk Factors And Pathogen Changes Of Neonatal Sepsis

Objective To analyze the high risk factors and pathogen changes of children with different types of sepsis,and provide theoretical basis for early identification of neonatal sepsis.Methods To collect the clinical datas of children diagnosed with neonatal sepsis and who were admitted to Ningxia critical care transfer center from January 2013 to December2019,to compare and analyze the differences of risk factors and the trend of pathogen changes.Results In the EOS group,the maternal hypertension during pregnancy was higher than that in the LOS group(P<0.05).The amniotic fluid pollution and the low Apgar score of the children were significantly higher than those in the LOS group(P<0.01).In the LOS group,the use of mechanical ventilation was significantly higher than the EOS group(P<0.01);there was no significant difference in arteriovenous placement between two groups(P>0.05).2.Among the 232 cases of premature sepsis,mechanical ventilation in the LOS group was significantly higher than that in the EOS group(P<0.01);there was no significant difference in arteriovenous placement between two groups(P>0.05).3.Among the 259 term infants with sepsis: the amniotic fluid pollution and low Apgar score in the EOS group were significantly higher than those in the LOS group(P<0.01).4.In EOS: the puerpera who had hypertension during pregnancy,a lower Apgar score and the use of mechanical ventilation of the neonatal in the group of preterm infant were higher than the term infant group(P<0.05).The puerpera who had infection in the late period of pregnancy and premature rupture of membranes were no significant difference between two groups(P>0.05).5.In LOS,the low Apgar score and mechanical ventilation of the preterm infants were significantly higher than the term infant(P <0.01).There was no significant difference in arteriovenous placement between the two groups(P>0.05).6.In the 491 children,94 blood cultures were positive.The proportion of Gram-positive bacteria was 51.1%,and the Gram-negative bacteria was 45.7%.7.In the EOS group,the proportion of Gram-negative bacteria(49.1%)was slightly higher than that of Gram-positive bacteria(47.1%);but in the LOS group,the proportion of Gram-positive bacteria(56.4%)was higher than that of Gram-negative bacteria(43.6%).8.Gram-positive bacteria showed an upward trend from 2013 to 2014,but there was a slight decline in 2015,turned to an upward trend from 2016 to 2017,a decline again in 2018,and a slight increase in 2019;Gram-negative bacteria was the opposite and not detected in 2017;the fungus was detected only in 2014~2016.9.The Klebsiella pneumoniae and Escherichia coli were not detected in 2015 and 2017,the overall trend were increasing.The overall trend of Listeria monocytogenes was upward,even if it was not detected in 2017 and 2018.Conclusion 1.Maternal hypertension during pregnancy,amniotic fluid pollution and low Apgar score are the high risk factors of EOS,especially in term infants,in which gestational hypertension leads to EOS in premature infants.2.The use of mechanical ventilation is a high risk factor for LOS,especially in premature infants.