极低/超低出生体重儿细菌性与真菌性晚发型败血症临床分析

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Abstract

Objective To analyze and compare the clinical features,pathogens and prognosis of bacterial and fungal late-onset sepsis(LOS)in very low/extremely low birth weight infants.Methods The clinical data of 62 infants with very low/extremely low birth weight sepsis who were admitted to the First Affiliated Hospital of Anhui Medical University from July 2015 to June 2020 were collected and retrospectively analyzed.According to the results of blood culture,they were divided into a bacterial group(n=37)and a fungal group(n=25).The incidence,mortality,and pathogenic bacteria of LOS of the two groups were counted,and the clinical manifestations and prognosis of the two groups were analyzed and compared.Results There were 1115 very low/extremely low birth weight infants during the study period,and the incidence of positive blood culture sepsis was 5.56%.The most common pathogen in the bacterial group was Klebsiella pneumonia(12 strains,19.35%),and the most common pathogen in the fungal group was Candida glabrata(11 strains,17.74%).In the fungal group,the incidence of apnea,abdominal distension/vomiting/retention,and splenauxe was higher than that in the bacterial group,and the difference was statistically significant(P<0.05).The incidence of increased heart rate in the bacterial group was higher than that of the fungal group,and the ratio of platelets <100×109/L was lower than that in the fungal group,and the differences were statistically significant(P<0.05).The values of C-reactive protein(CRP)and procalcitonin(PCT)were higher than those in the fungal group,and the differences were statistically significant(P<0.05).The complication of central nervous system infection in the bacterial group was lower than that in the fungal group,and the difference was statistically significant(P<0.05).Conclusion The incidence of LOS in very low/extremely low birth weight infants is high.The clinical manifestations at onset are not specific.Increased heart rate,elevated CRP and PCT indicate bacterial infection.Apnea,abdominal distension,vomiting,retention,splenauxe,and decreased platelet are more indicative of fungal infection.Children with fungal infection are more likely to develop central nervous system infection than those with bacterial infection.

Key words： Very low birth weight infant Extremely low birth weight infant Late-onset sepsis Clinical analysis

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	ZHU Qian-qian
	WANG Li-li

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ZHU Qian-qian,WANG Li-li. Clinical analysis of bacterial and fungal late-onset sepsis in very low/extremely low birth weight infants[J]. 中国当代医药, 2021, 28(24): 162-166.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I24/162

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