Neonatal sepsis in Jamaican neonates
Neonatal sepsis in Jamaican neonates
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DOI：
10.1179/146532805x72449
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发表时间：
2005-12-01
影响因子：
--
通讯作者：
Trotman, H
中科院分区：
文献类型：
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作者：
Bell, Y;Barton, M;Trotman, H
目的：确定西印度群岛大学医院新生儿细菌性脓毒症的发病率和致病微生物。方法：对1995年1月至2000年12月间入院的所有经培养证实的脓毒症新生儿进行回顾性分析。发病率和抗菌药物的敏感模式determined.Results：有4702新生儿病房在研究期间的入院。其中，135例经培养证实患有败血症，115例为先天性，发病率为6.7/ 1000活产。血培养阳性89例，尿培养阳性51例，脑脊液培养阳性2例。最常见的微生物是克雷伯菌属（28%）。其他微生物包括大肠杆菌（16%）、B族链球菌（11%）和肠杆菌属（10%）。克雷伯菌属对氨基糖苷类抗生素的耐药率为46%，有7株多重耐药。病死率为6.7%。结论：西印度群岛大学医院的新生儿护理医生需要认识到克雷伯菌在新生儿败血症中的重要作用及其对新生儿死亡率的贡献。革兰氏阴性脓毒症的经验性抗生素治疗方案必须考虑到目前普遍存在的氨基糖苷类抗生素耐药率高的问题。
Aim: To determine the incidence and causative organisms of bacterial sepsis in neonates at The University Hospital of the West Indies.Methods: A retrospective review of all neonates with culture- proven sepsis admitted to the hospital between January 1995 and December 2000 was conducted. Incidence rates and antimicrobial susceptibility patterns were determined.Results: There were 4702 admissions to the neonatal unit during the study period. Of these, 135 had culture- proven sepsis and 115 were inborn, giving an incidence of 6.7/ 1000 live births. There were 89 positive blood cultures, 51 positive urine cultures and two positive CSF cultures. The single most common organism was Klebsiella spp ( 28%). Other organisms included Escherichia coli ( 16%), group B Streptococcus ( 11%) and Enterobacter spp ( 10%). The aminoglycoside resistance rate of Klebsiella spp was 46% and seven isolates had multiple resistance to antibiotics. There was a case fatality rate of 6.7%.Conclusion: Physicians involved in newborn care at The University Hospital of the West Indies need to recognise the important role Klebsiella now plays in neonatal sepsis and its contribution to neonatal mortality. Empirical antibiotic regimens for gram- negative sepsis must take into consideration the high rates of aminoglycoside resistance that are now prevalent.