Clinical Analyses Of Neonatal Necrotizing Enterocolitis Complicated-septicemia

Objective: To study the incidence, risk factors and pathogens ofneonatal necrotizing enterocolitis (NEC) complicated-septicemia.Method: The clinical features were analyzed retrospectively in277newborns suffering from NEC, pathogens results of blood and peritonealfluid culture samples were analyzed in infants with NECcomplicated-septicemia, who were medically treated in affiliated Children’sHospital of Chongqing Medical University from July2000to February2013.Results: The incidence of NEC complicated-septicemia was28.5%(79/277), which was higher in preterm group (p=0.049). Among79neonates, there were32preterm infants (40.5%). The average gestationalage and birth weight were (36.62±3.26) weeks and (2551.06±737.90)grams, respectively. The average day of onset was (10.30±12.18), ofwhich the preterm group was (12.90±16.23), the smaller the gestationalage, the later the onset time. The mainly prenatal factors were infectiousdiseases, premature rupture of membranes (PROM) and amniotic fluidabnormalities. The chief clinical manifestations were abdominal distension,vomiting, apathetic and hyperbilirubinemia. The other accompaniments or complications were pneumonia, intestinal perforation and peritonitis.Seventy two cases (91.1%) met the clinical diagnostic criteria in bloodanalysis. Finally,19infants (24.1%) were cured,28infants (35.4%) wereimproved, while9infants (11.4%) were given up and23infants (29.1%)died. Most infants belonged to stage Ⅲ (49cases,62.2%). Out of72bloodand peritoneal samples:13kinds,38stains were detected. The positive ratesof blood and peritoneal culture were46.9%and66.7%, respectively.Escherichia coli (29.1%) and Klebsiella pneumoniae (29.1%) were the mostcommon pathogens.Conclusion: Infants with NEC (stageⅡ or Ⅲ) are prone to complicatewith septicemia. Once definite diagnosis of NEC has been made, bloodcultures should be routinely done, emphasis on anaerobic cultures, andmonitors the laboratorial index regularly as to reduce the possibility ofoccurrence of gut-derived septicemia.