Escherichia coli:: a growing problem in early onset neonatal sepsis
Escherichia coli:: a growing problem in early onset neonatal sepsis
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DOI：
10.1111/j.1479-828x.2004.00304.x
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发表时间：
2004-12-01
影响因子：
1.7
通讯作者：
Battin, MR
中科院分区：
文献类型：
--
作者：
Jones, B;Peake, K;Battin, MR
目的：回顾早期新生儿大肠杆菌败血症的人口学特征、前因和结果。次要目的是确定产前抗生素的使用情况并审查抗菌药物敏感性。方法：对 1998 年 1 月至 2002 年 10 月期间获得的血液或脑脊液样本中大肠杆菌培养呈阳性的所有婴儿进行回顾性图表审查。结果：确定了 19 名患有早发败血症的活产婴儿和 1 名母体血培养大肠杆菌呈阳性的死产婴儿。妊娠并发症包括多胎妊娠 5 例 (25%)、胎膜早破 10 例 (50%) 和产妇尿路感染 5 例 (25%)。其中十八例早产，两例足月出生。死亡率为 8/20 (40%)，在有发育结果数据的 9 例病例中，67% 处于正常范围内，33% 异常。在 20 株大肠杆菌分离株中，11 株（55%）对阿莫西林耐药，1 株（5%）对庆大霉素耐药。结论：早发大肠杆菌败血症的婴儿预后不良，死亡率高，三分之一的幸存者表现出神经发育障碍。尽管阿莫西林耐药很常见，但当地分离株庆大霉素耐药的发生率较低。
Aims: To review the demographic characteristics, antecedents and outcome for early neonatal Escherichia coli sepsis. Secondary aims were to identify antenatal antibiotic use and to review the antimicrobial susceptibility.Methods: A retrospective chart review was performed for all infants with a positive culture for E. coli from either blood or CSF samples obtained between January 1998 and October 2002.Results: Nineteen liveborn infants with early onset sepsis and one stillborn baby with a positive maternal blood culture for E. coli were identified. Pregnancy complications included multiple pregnancy in five (25%), preterm rupture of membranes 10 (50%) and maternal urinary tract infection in five (25%). Eighteen of the cases were born preterm and two at term. The mortality was 8/20 (40%), and for nine cases with developmental outcome data available, 67% were within normal limits and 33% were abnormal. Of the 20 E. coli isolates 11 (55%) were resistant to amoxycillin and 1 (5%) was resistant to gentamicin.Conclusions: Infants with early onset E. coli sepsis had a poor outcome with high mortality and a third of the survivors manifesting neurodevelopmental impairment. Although amoxycillin resistance is common, there is a low prevalence of gentamicin resistance in local isolates.