| Objective We took a retrospective analysis on patients with sepsis which were hospitalized in Chen Zhou NO.1 People’s Hospital affiliated to University of South China, and to investigate the incidence, pathogenic bacteria distribution and drug resistance characteristics of neonates with sepsis, also to provide scientific advice for the clinical treatment of sepsis.Methods Clinical data about neonates with sepsis were collected in Chen Zhou NO.1 People’s Hospital affiliated to University of South China, from 2007 January to 2014 December, then analyzed pathogenic bacteria distribution and drug sensitivity in neonates with sepsis.Results 1 Total of 608 neonates with sepsis were collected, these cases accounted for 2.62%(608 / 23224), 196 cases were diagnosed by clinical diagnosis, the others by definite diagnosis. The incidence of sepsis was 2.85% in first 4 years(383/13419), higher than incidence in later 4 years the(2.58%,225/9805), there were a significant difference between two groups(P < 0.05). 2 There were 412 cases with pathogenic bacteria were detected by bacteria culture, and the incidence of G+ bacteria, G- bacteria and fungi were 62.38%, 30.34% and 7.28%, respectively. 155 strains were detected in first 4 years, the number of G+ bacteria, G- bacteria and fungi were 106 strains(68.39%), 40 strains(25.80%), 9 strains(5.81%), respectively; and the CONS accounted for 90.57% G+ strains. Klebsiella pneumoniae were detected in the later 4 years, G+ bacteria, G- bacteria and fungi were 151 strains(58.76%), 85 strains(33.07%), 21 strains(8.17%); the CONS accounted for 74.83% G+ strains, Klebsiella pneumoniae and Escherichia coli G- strains accounted for 30.58% and 35.29%. there were a significant difference between two groups on CONS and Escherichia coli(P < 0.05) 3 Total 60 strains of pathogenic bacteria were detected in GA < 32 weeks group, and the number of G+ bacteria, G- bacteria and fungi were 15 strains(25%), 22 strains(36.67%), 23 strains(38.33%),respectively; 77 strains of pathogenic bacteria were detected in 32 < GA < 37 weeks group, and the number of G+ bacteria, G- bacteria and fungi strains were 32(41.56%), 39(50.65%) and 6(7.79%), respectively; 275 strains of pathogenic bacteria were in detected GA was more than 37 weeks group, and the number of G+ bacteria, G- bacteria and fungi were 210 strains(76.36%), 63 strains(22.91%), 2 strains(0.73%),respectively; There was a significant difference in different gestational age group with species constitution ratio(P < 0.05). 4 Total 201 strains of pathogenic bacteria were detected in Early-onset sepsis, the number of G+ bacteria, G- bacteria and fungi strains were 136(67.66%), 58(28.86%) and 7(3.49%); Total 211 strains of pathogenic bacteria were detected in late-onset sepsis, the number of G+ bacteria, G- bacteria and fungi strains were 121(57.35%), 67(31.75%), 23(10.90%), respectively;. There was a significant difference between two groups with the ratio of G+ bacteria or fungi(P < 0.05). 5 Total 47 strains of pathogenic bacteria were detected in Invasive operation related sepsis, the number of G+ bacteria, G- bacteria and fungi strains were 8(17%), 17(36.2%) and 22 strains(46.8%).6 Total 341 strains of pathogenic bacteria were detected in Community infection patients, the number of G+ bacteria, G- bacteria and fungi strains were 244(71.55%), 95(27.86%),and 2(0.58%), respectively; 71 strains of pathogenic bacteria were detected in neonate infection in hospital. the number of G+ bacteria, G- bacteria and fungi strains were 13(18.31%), 30(27.80%) and 28(39.44%); There was a significant difference between two groups(P < 0.05). 7 G+ bacteria were resistant to penicillin, oxacillin and macrolide,(no vancomycin) but were sensitive piperacillin, tazobactam, quinolone antibiotics.; G- bacteria generally was resistant to ampicillin and cephalothin antibiotic, but was sensitive to the beta lactamase inhibitor compound preparation and quinolones,also very sensitive to carbapenems;fungi generally was sensitive to conazole.Conclusion The pathogen in neonatal septicemia were dominated by CONS, followed by Klebsiella pneumoniae and Escherichia coli; Most pathogen of community infection were G+ bacteria, infection in hospital were G- bacteria and fungi; the smaller gestational age, invasive operation more, the higher the proportion of mitosporic fungi. The main G+ bacteria and G- bacteria are generally resistant to penicillin and cephalosporins, carbapenems antibiotics for sensitive high; fungi generally sensitive to azole drugs. |
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