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在出生体重非常低的婴儿中晚期发作的败血症

Gil Klinger^1,2, Ruben Bromiker^1,2, Inna Zaslavsky-Paltiel³

¹Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

|October 3, 2023

概括

在怀孕27周之前出生的婴儿的出生体重非常低 (VLBW) 面临着晚发性败血症的最高风险. 在过去的25年中,VLBW婴儿的败血症率显著下降,格兰美阳性,格兰美阴性和真菌感染的显著减少.

科学领域:

新生儿科学新生儿科学
传染性疾病传染性疾病
流行病学流行病学

背景情况:

晚发性败血症 (LOS) 对非常低出生体重 (VLBW) 婴儿构成重大威胁,导致大量的发病率和死亡率.
识别风险因素和了解LOS的时间趋势对于改善这一脆弱人群的结果至关重要.

研究的目的:

确定与VLBW婴儿晚发性败血症发展相关的关键风险因素.
在25年的时间内分析LOS总和病原体特定率的时间趋势.

主要方法:

一项基于人口的研究分析了1995年至2019年间出生的31,612名VLBW婴儿的数据.
使用双变量和多变量分析来确定LOS的风险因素,这些风险因素是由临床症状和微生物学证据来定义的.
研究期间被分为四个时代,以比较 LOS 率的时间变化.

主要成果:

在怀孕27周之前出生的婴儿和需要分娩室复苏的婴儿有明显增加的LOS风险.
观察到LOS率显著下降,从29.5% (1995-2000年) 降至13.0% (2013-2019年).
病原体特异性率下降,所有时代的格拉姆阴性和真菌感染显著减少,最近的时代的格拉姆阳性感染显著减少.

结论:

怀孕年龄小于27周是VLBW婴儿中LOS最强的危险因素.
在25年内,病原体特定的LOS率在细菌感染中大约下降了两倍,在真菌感染中下降了六倍.
这些发现突出了对VLBW婴儿的新生儿护理和感染控制策略的改进.

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