Study On Effects Of Culture And PCR Results On Antibiotics Therapy In Infants With GBS Infection In 0-3 March

Objective:Comparison of non-specific inflammatory indicators,involvement of various organ systems,prognosis and effect on different antibiotic therapies in infants with GBS infection in the period of February to March.Methods:80 cases of GBS-infected children who were hospitalized from January 2014 to June 2018 in the neonatal consultation center of the children's hospital affiliated with Chongqing Medical University(including the neonatal intensive care unit) were selected and divided into PCR positive group and culture positive group according to the test results.According to the treatment plan,it is divided into penicillin combined with oxygen cef/third generation cef/third generation(penicillin+group) and glycopeptides combined with three generations of cef/hydrocarbene(glycopeptides+group).Retrospective analysis of its clinical performance,laboratory examination,treatment and transition.Result:In 80 cases,48 cases were PCR positive group and 32 cases were culture positive group.The incidence of white blood cell abnormalities,CRP abnormalities,PCT abnomalies,PCT>100 and platelet reductions were higher in the positive culture group than the PCR group.They are 62.5%vs 20.8%(x~2=12.5)?81.2% vs 37.5%(x~2=13.133)?84.3%vs 52%(x~2=7.438)?34.3%vs 6.25%(Fisher,exact probability method,there is no x~2)?21.8% vs 4.1%(Fisher,exact probability method,there is no x~2),p<0.05?The positive culture rate of I/T increased(9.3%) was lower than that of PCR(12.5%),and the difference between the two groups was not statistically significant(p>0.05).The positive culture of sepsis,septic shock,purulent meningitis,neonatal necrotizing enterocolitis,liver function damage,renal function damage,and electrolyte disorders was higher than that of the PCR positive group.They are 96.8% vs 70.8%?12.5% vs 0%?37.5% vs 4.1%?25% vs 4.1%?21.8% vs 2.08%,28.1% vs 2.08%?31.25% vs 12.5%(x~2=4.219),all p<0.05,The difference between the two groups was statistically significant.Pneumonia rate of culture positive group(71.8%) than PCR positive group(95.8%) low,p<0.05,the difference is statistically significant.Respiratory failure,myocardial damage,clotting dysfunction,and abnormal blood sugar culture were higher in the culture positive group than in the PCR positive group,but there was no statistically significant difference between the two groups.The mortality rate and the incidence of dural effusion sequelae were higher in the culture positive group than in the PCR positive group,which were18.75% vs 0%(p=0.003) and 12.5% vs 0%(p=0.023) respectively,the difference between the two groups was statistically significant.Compared with the glycopeptides+scheme and penicillin+scheme in children with positive culture group,the improvement rate of the two groups were 88.9%vs 81.8%(x~2=0.627,p=1),and the difference was not statistically significant;The time of hospitalization was shorter in penicillin+group,and the length of hospitalization days(median comparison)of the two groups was 10d vs 13d(p=0.135),and the difference was not statistically significant.The hospitalization cost of penicillin+group was lower,and the two groups(median comparison) were ?7870.71vs?23047.87 respectively,which was statistically significant(non-parametric rank and test,p=0.003).Comparison of penicillin+scheme and glycopeptides+scheme in children with PCR positive group,The improvement rate of the two groups were 100%.The number of days in hospital penicillin+group was shorter,and the two groups were 10d vs15d(p=0.015) respectively,the difference was statistically significant;The hospitalization cost of penicillin+group was lower,and the two groups(median comparison) were ?13517.65vs ?29915.81,the difference is statistically significant(non-parameter rank and test,p=0.003).Conclusion:Children with GBS positive bacterial culture had a higher incidence of Leukocyte abnormalities,CRP abnormalities,PCT abnormalities,PCT>100 incidence,and platelet reductions than children with GBS-PCR positive.The incidence of sepsis,septic shock,suppurative meningitis,neonatal necrotizing enterocolitis,liver and kidney damage,and electrolyte disorders is higher and the condition is more serious.penicillin combined with oxycephalospor/third generation cephalospora is effective,reasonable and less costly in the treatment of GBS infection.