Analysis of positive umbilical cord blood culture results in 111 neonates with early onset sepsis
10.3760/cma.j.issn.1673-4408.2024.09.012
- VernacularTitle:111例新生儿早发型败血症脐血培养阳性结果分析
- Author:
Tong DONG
1
;
Rong TAO
;
Yingying BAO
Author Information
1. 浙江大学医学院附属妇产科医院新生儿科，杭州 310000
- Keywords:
Infant，newborn;
Early onset sepsis;
Umbilical cord blood culture;
Pathogens;
Drug resistance
- From:
International Journal of Pediatrics
2024;51(9):634-638
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate and evaluate the pathogenic bacterial composition，drug susceptibility of pathogens，and the time to positive in umbilical cord blood culture（UCBC）of newborns with early onset sepsis（EOS）.Methods:The clinical data of 111 newborns with EOS with positive UCBC admitted to the neonatology department in Women's Hospital School Medicine of Zhejiang University from 1st January 2021 to 31st December 2022 were retrospectively analyzed.The patients were divided into Gram-positive bacteria group，Gram-negative bacteria group and fungal group.The pathogenic bacteria composition，drug susceptibility of pathogens and time to positive in UCBC of the three groups were compared.Results:A total of 114 strains of bacteria were isolated from 111 neonates and 2 types of pathogenic bacteria were cultured from 3 newborns of UCBC.Among the 114 pathogenic bacteria，69 strains were Gram-positive，accounting for 60.5%，and the Gram-positive bacteria were mainly Enterococcus faecalis and Group B streptococcus（GBS）.There were also 43 Gram-negative strains accounting for 37.7%，primarily Escherichia coli.Two strains of fungi，both of which were Candida albicans，accounted for 1.8%.Additionally，the time to positive in UCBC varied among different pathogens.Gram-positive bacteria had a significantly longer detection time than Gram-negative bacteria［（36.3（21.6，48.2）hours vs.20.4（16.5，33.8）hours）， Z=3.539， P<0.01］.The rate of drug resistance was found to be high in Enterococcus faecalis against tetracycline（52.9%）and erythromycin（47.1%）.GBS showed resistance against clindamycin（87.5%）and erythromycin（75.0%）.Both Enterococcus faecalis and GBS exhibited sensitivity towards penicillin，linezolid，and vancomycin.Among Gram-negative bacteria，Escherichia coli was sensitive to imipenem，ertapenem，cefoxitin，cefoperazone-sulbactam，amikacin and tigecycline，and had a high resistance rate to cotrimoxazole（61.3%）. Conclusion:Enterococcus faecalis，GBS，and Escherichia coli were predominant microorganisms identified in UCBC of newborns with EOS.The positive time for Gram-negative bacteria in UCBC was significantly shorter compared to Gram-positive bacteria，while the bacteria isolates from UCBC exhibited a low resistance rate to commonly used antibiotics.
