| 肖婷娟,黄华飞,单丽琴,周庆女.新生儿李斯特菌败血症5例临床分析[J].浙江中西医结合杂志,2017,27(8): |
| 新生儿李斯特菌败血症5例临床分析 |
| Clinical analysis of 5cases of listeria sepsis |
| 投稿时间：2016-12-25 修订日期：2017-03-09 |
| DOI： |
| 中文关键词: 李斯特菌 败血症 新生儿 |
| 英文关键词:Listeriosis Septicemia Neonatal |
| 基金项目:嘉兴市科学技术局资助项目（2014AY21050） |
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| 中文摘要: |
| 目的 探讨新生儿李斯特菌败血症的临床诊治要点。方法 回顾性分析2012年1月至2016年9月期间我院新生儿重症监护病房收治、血培养阳性的产单核细胞增生性李斯特菌败血症新生儿,记录母亲围产期情况以及患儿临床表现、合并症、实验室检查、治疗、预后。结果 共收治5例新生儿李斯特菌败血症患儿,所有患儿母亲围产期均有发热和羊水浑浊。早产儿2例,足月儿3例。患儿48小时内发病4例,>7天发病1例。主要临床表现为发热、纳差、反应差、呼吸困难、青紫,4例合并化脓性脑膜炎。2例白细胞计数明显升高,5例C反应蛋白均明显升高。治疗：根据血培养药敏试验和临床治疗效果,最终单用青霉素1例,单用万古霉素4例。转归：治愈4例,好转签字出院1例。结论 早期病原微生物诊断及早期应用有效抗生素治疗李斯特菌败血症可以提高治愈率。 |
| 英文摘要: |
| Objective To investigate the clinical features and therapy of listeria sepsis. Methods Retrospectively analyzed 5 cases of listeria sepsis in the newborn received by neonatal intensive care unit of the hospital from January 2012 to September 2016 whose diagnosis of listeria sepsis were confirmed by blood culture. Data collected included maternal perinatal events, patients’ clinical feature, complications, laboratory finding, treatment and prognosis. Results Among 5 cases in this study, all patients’ mothers had history of perinatal fever and amniotic fluid turbidity, two were preterm infants, while others were full term infants. Four patients produced symptoms within 48 hours after birth, the other one after 7 days of birth. Clinical features included fever, lack of appetite, poor response, respiratory difficulty, cyanoderma. Four patients had purulent meningitis. Laboratory findings showed significantly elevated white blood cell count (2 cases)and C-reactive protein (5 cases). According to blood culture drug susceptibility test and clinical therapeutic effect, the final use of penicillin in 1 case, 4 cases were vancomycin alone. Four patients were cured, one improved and left hospital. Conclusion Early diagnosis of pathogenic microorganisms and early application of effective antibiotics for listeria sepsis can improve the cure rate. |
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