新生儿败血症的流行病学和结果:来自澳大利亚第三级NICU的经验
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Cheryl Anne Mackay1,2, Elizabeth A Nathan2, Michelle Claire Porter3
1Neonatal Directorate, Child and Adolescent Health Service, King Edward Memorial Hospital, Subiaco, Washington, Australia.
Neonatology
|June 18, 2024
概括
新生儿败血症,特别是晚发性败血症 (LOS),仍然影响婴儿,导致更高的死亡率和长期健康问题. 虽然LOS发生率下降,但败血症仍然是新生儿的重大风险,影响大脑发育和生存.
科学领域:
- 新生儿科学 新生儿科学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 新生儿败血症是一个重大的全球卫生挑战,在中低收入国家产生不成比例的影响.
- 晚发性败血症 (LOS) 即使在高收入国家仍然是一个问题,影响高达20%的早产婴儿 (<28周怀孕).
- 具体地点的数据对于有效的管理策略至关重要.
研究的目的:
- 确定三级医院中早期发作的败血症 (EOS) 和晚期发作的败血症 (LOS) 的发生率和病因.
- 分析新生儿败血症和不良结果之间的关联.
- 为了评估十年来LOS发病率的趋势.
主要方法:
- 在珀斯的爱德华国王纪念医院 (KEMH) 进行了一项回顾性队列研究.
- 数据是从2012年1月至2022年6月期间入院的婴儿的电子数据库中提取的.
- 分析了新生儿败血症的发病率,病因和结果.
主要成果:
- 在23,395例入院中,在350名婴儿中共发现了370例败血症发作.
- EOS主要是由Streptococcus agalactiae和埃舍里希亚大肠杆菌引起的; LOS主要是由于凝血酶阴性葡萄球菌 (CONS) 和大肠杆菌.
- 从2012年到2022年,LOS的发生率显著下降 (p = 0.002).
- 败血症与增加的死亡率,更长的住院时间,脑损伤,死性肠球炎 (NEC),慢性肺病 (CLD) 和神经发育障碍有关,特别是在早产婴儿中.
结论:
- 尽管LOS发病率有所降低,但新生儿败血症仍与死亡率和发病率的增加有关.
- 败血症的幸存者面临长期住院和长期并发症的更高风险,包括脑损伤,NEC,CLD和神经发育障碍.
- 了解当地流行病学数据对于完善临床管理和改善败血症新生儿的治疗结果至关重要.
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