The Clinial And Pathogenic Analysis Of Bacterial Infectious Diseases In Neonates

Objective:The clinical manifestations of bacterial infectious diseases in neonates are infinite various. Symptoms and physical signs have no specificity. So it is difficult to make pathogenic diagnosis according to the clinical features. Currently, as the tests of bacteria and drug sensitivity could not be finished in a short time which lead it difficult to make a diagnosis in the early stage. Besides, the infections from conditioned pathogen and drug-fast bacteria increased annually, therefore, how to make a diagnosis and how to use the antibiotics reasonablely is important. In the present study, we collected and analysed the clinical manifestation, pathogens distribution, bacterial susceptibility and drug resistance in 73 neonates with bacterial infection, try to figure out the relationship between neonates and abnormal birth history, and offer essential diagnostical data for correct and seasonable diagnosis and treatment of neonatal infectious diseases.Methods:Selected 73 in-hospital in Qilu Hospital of Shandong University with positive bacterial culture cases of neonatal infectious diseases from January to June,2009. Analyzed and summarized the clinical manifestation, abnormal birth history, primary diseases, auxiliary examination, pathogens distribution, drug sensitivity and drug resistance, therapy and return, blood and sputum cultures, umbilical secretion culture and others, and studied the relationship between abnormal birth history and neonatal infectious diseases.Results: â… .32 samples of early newborns were collected, including 21 males and 11 females; 41 samples of late newborns were collected, including 28 males and 13 females.â…¡.There were 43 cases with abnormal birth history, including 28 early stage neonates and 15 late stage neonates. There was significantly different between early and late stage neonates (p< 0.01)â…¢.Amniotic fluid pollution, umbilical cord around neck, asphyxiation, premature rupture of fetal membranes and fetal distress in uterus were the top 5 diseases of abnormal birth history in this article.â…£. The most common disease was pneumonia of newborn in neonatal bacterial infection, septicemia, omphalitis of newborn and the other cutaneous were following.â…¤.The common symptoms in neonatal infectious diseases were weak reaction,jaundice, milk feeding change and low crying, which were 25cases (34.25%),27 (36.99%),22 (30.14%) and 8 (10.96%) cases respectively.â…¥.Their serum myocardial enzymes, liver function and renal function were tested in 73 cases of neonatal bacterial infection, While 65 cases(89.04%),50 cases(68.49%),24 cases(32.88%) of the 73 newborns had abnormal changes.â…¦.The top 5 pathogenic bacteria from bacteria culture of specimen were: Streptococcus viridians, Dry Neisseria, tetrads, K. pneumonia, Escherichia coli. The top 3 pathogenic bacteria from bacteria culture of blood were:Staphylococcus epidermidis, Staphylococcus haemolyticus and K. pneumonia. The top 5 pathogenic bacteria from bacteria culture of Umbilical secretion were:K. pneumonia, Escherichia coli and Staphylococcus haemolyticus, Staphylococcus epidermidis and Bacillus levans; The most common pathogenic bacteria from bacteria culture of secretion from skin etc.was the Staphylococcus aureus.â…§.The results showed that 105 species of pathogens cultured from 73 samples. The top 3 pathogenic bacterias from bacteria culture were:Staphylococcus epidermidis, Staphylococcus haemolyticus and K. pneumonia. The drug sensitive rates of the Staphylococcus epidermidis to Teicoplanin and VCM were100%.The drug resistance rates of the Staphylococcus epidermidis to Penicillin, Erythromycin, MPIPC, SMZ-TMP, Clindamycin were 95.45%,86.36%,81.82% and 72.73%. The drug sensitive rates of Staphylococcus haemolyticus to Teicoplanin, VCM and Rifampicin were 100%. The drug resistance rates of Staphylococcus haemolyticus to Penicillin, Erythromycin, MPIPC, Norfloxacin, and SMZ-TMP were 100%,88.24%, 76.47%,58.82% and 42.68%. The drug sensitive rate of the K. pneumonia to Meropenem were 100%. The drug resistance rate of the K. pneumonia to Ampicillin was 92.86%, to CEZ,ceftazidime,Piperacillin, CXM and Ceftizoxime(CZX) all reached to 57.14%, to Imipenem was 7.14%, to Cefoperazone sodium and Sulbactam sodium was 14.29%.IX.Among 73 patients with neonatal infectious diseases studied:the total effective rate reached to 61.64% with 45 cutable cases,20 effective cases (27.40%),3 cases (4.1%) were discharged with against-advise,3 cases (4.1%) died.Conclusions:â… .Staphylococcus epidermidis, Staphylococcus haemolyticus and K. pneumonia are the main pathogenic bacterias of the neonatal infectious diseases.â…¡.There is a close correlation between abnormal birth history and early stage neonates.â…¢.Good effective results could be achieved by utiliting the conresponding antibiotics reasonablely.