Analysis Of Clinical Characteristics Of Neonatal Sepsis And Investigation On The Evaluation Value Of Sepsis Risk Calculator

Objective: To collect the data of neonates with sepsis in our hospital in the past three years,and to summarize and analyze its characteristics.To evaluate the value of sepsis risk calculator(SRC)in the evaluation of Early-onset sepsis(EOS)in neonates.Methods:The clinical data of neonates with neonatal sepsis admitted to the Department of Neonatology,the First Affiliated Hospital of Xinjiang Medical University from 2019 to2021 were collected.According to the time of onset,the neonates were divided into early-onset sepsis(EOS)group and Late-onset sepsis(LOS)group.The clinical manifestations,pathogen detection and antibiotic resistance of children in different groups were analyzed.The neonates with gestational age ≥34 weeks and suspected EOS admitted to the department from January to June 2022 were selected as the study group.SRC was used to calculate the risk of EOS,and SRC recommended the corresponding diagnosis and treatment measures combined with clinical manifestations.The consistency between the recommended diagnosis and treatment measures of SRC and the clinical practice were compared.Results: 1)A total of 310 cases of neonatal sepsis were enrolled in the past 3 years,including 258 clinically diagnosed cases and 52 confirmed cases.There were 282 cases in the EOS group and 28 cases in the LOS group.Compared with the EOS group,the LOS group had more common decreases in WBC and PLT count and increases in CRP.2)The number of positive blood culture cases was 53,and 53 strains were cultured.The main pathogens were Gram-negative bacteria,and Escherichia coli ranked the first.Escherichia coli was the most common pathogen in EOS,and Klebsiella was the most common pathogen in LOS.3)Among the 96 neonates with suspected EOS in the study group,15 were diagnosed with EOS.For neonates with suspected EOS,SRC was used to predict the risk of EOS and give corresponding diagnosis and treatment measures.Forty-six neonates with suspected EOS were recommended to use antibiotics,with a utilization rate of 47.92%,while the actual clinical antibiotic utilization rate was93.75%,and the difference was statistically significant(P<0.05).Sixty-eight blood culture specimens were recommended by SRC,with a submission rate of 70.83%,while the actual specimen submission rate was 65.63%,and the difference was statistically significant(P<0.05).Conclusions: 1)Among the neonates with sepsis,early-onset and late-onset neonates have their own characteristics in clinical manifestations,laboratory test results,and distribution of pathogens during hospitalization.2)The use of SRC will help to reduce the rate of antibiotic use in children with early suspected sepsis and guide the rational use of blood culture.