Clinical Characteristics,Pathogenic Distribution And Drug Susceptibility Analysis Of Neonatal Sepsis

Objective:To explore the clinical symptoms and signs,related risk factors,the distribution of pathogenic bacteria and the results of drug sensitivity of neonatal sepsis,so as to provide certain basis for clinicians to make early diagnosis and guide clinicians to select appropriate antibiotics in the early treatment of neonatal sepsis.Methods:A total of 195 confirmed cases of neonatal sepsis among 10,416 children admitted to the neonatology ward of Chaohu Hospital of Anhui Medical University from2015 to 2022 were selected as the research objects of this study.According to the time of onset of neonatal sepsis symptoms,the children were divided into early-onset neonatal sepsis group(birth age<3 days,n=78)and late-onset neonatal sepsis(age of birth>3 days,n=117).The general birth data,clinical symptoms and signs,related risk factors,common pathogenic bacteria and the characteristics of drug susceptibility were compared statistically between the two groups.Results:In this study,it was found that the incidence of perinatal premature rupture of membranes>18h in the early onset group was higher than that in the late onset sepsis group,and the difference was statistically significant(x~2was 9.247,5.611,P<0.05).In comparison of clinical symptoms and signs,the incidence of lactation rejection,shortness of breath,poor response and dyspnea in the early-onset group was higher than that in the late-onset group,and the difference was statistically significant(x~2was 20.267,21.929,8.897,28.598,P<0.05).The incidence of fever,cough and jaundice in the late onset group was higher than that in the early onset group,and the difference was statistically significant(x~2was 7.895,26.090,12.416,P<0.05).In comparison of non-specific indicators,abnormal PCT,WBC and PLT were more common in the early-onset group than in the late-onset group,and the differences were statistically significant(x~2was 4.969,8.075,6.003,P<0.05).Abnormal CRP was more common in late onset group than in early onset group,and the difference was statistically significant(x~2was 8.921,P<0.05).Among 195 confirmed cases of neonatal sepsis,a total of 125 pathogenic bacteria were detected,among which,Gram-negative bacillus was the most common in the early onset sepsis group,while Gram-stained positive coccus was the most common in the late onset sepsis group,with statistically significant differences(x~2was 15.646,12.191,P<0.05).Conclusion:For neonates with associated risk factors of premature rupture of membranes>18h and history of asphyxia,clinical dyspnea,lactation rejection,shortness of breath,poor response and abnormalities of PCT,WBC and PLT,it is necessary to be alert to the occurrence of early onset sepsis.Children with jaundice,cough,fever and abnormal CRP should be vigilant about the occurrence of late-onset sepsis.The most common pathogenic bacteria in the early-onset group were gram-negative bacilli,while the most common pathogenic bacteria in the late-onset group were gram-positive cocci,and sensitive antibiotics were selected to treat the early experience.