Early-onset Sepsis Among Preterm Neonates in China, 2015 to 2018

被引：50

作者：

Jiang, Siyuan ^{[1
]}

Hong, Luyang ^{[1
]}

Gai, Jianfang ^{[2
]}

Shi, Jingyun ^{[3
]}

Yang, Yi ^{[4
]}

Lee, Shoo K. ^{[5
,6
,7
,8
,9
]}

Cao, Yun ^{[1
,4
]}

Ji, Yong ^{[10
]}

Han, Shuping ^{[11
]}

Wang, Sannan ^{[12
]}

Li, Zhankui ^{[13
]}

Xia, Shiwen ^{[14
]}

Yang, Changyi ^{[15
]}

Yang, Chuanzhong ^{[16
]}

Chen, Ling ^{[17
]}

Yuan, Jing ^{[18
]}

Liu, Ling ^{[19
]}

Yi, Bin ^{[20
]}

Lin, Zhenlang ^{[21
,22
]}

Wang, Yang ^{[23
]}

Liu, Jiangqin ^{[24
]}

He, Ling ^{[25
]}

Li, Mingxia ^{[26
]}

Pan, Xinnian ^{[27
]}

Guo, Yan ^{[28
]}

Liu, Cuiqing ^{[29
]}

Zhou, Qin ^{[30
]}

Li, Xiaoying ^{[31
]}

Xiong, Hong ^{[32
]}

Qi, Yujie ^{[33
]}

Hei, Mingyan ^{[34
]}

机构：

[1] Fudan Univ, Childrens Hosp, Dept Neonatol, 399 Wanyuan Rd, Shanghai 201102, Peoples R China

[2] Childrens Hosp Shanxi, Dept Neonatol, Taiyuan, Shanxi, Peoples R China

[3] Gansu Prov Maternal & Child Hosp, Dept Neonatol, Lanzhou, Gansu, Peoples R China

[4] Fudan Univ, NHC Key Lab Neonatal Dis, Shanghai, Peoples R China

[5] Univ Toronto, Mt Sinai Hosp, Maternal Infant Care Res Ctr, Toronto, ON, Canada

[6] Univ Toronto, Mt Sinai Hosp, Dept Pediat, Toronto, ON, Canada

[7] Univ Toronto, Dept Pediat, Toronto, ON, Canada

[8] Univ Toronto, Dept Obstet & Gynecol, Toronto, ON, Canada

[9] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[10] Childrens Hosp ShanXi, Womens Hlth Ctr Shanxi, Taiyuan, Shanxi, Peoples R China

[11] Nanjing Med Univ, Womens Hosp, Nanjing, Jiangsu, Peoples R China

[12] Suzhou Municipal Hosp, Suzhou, Jiangsu, Peoples R China

[13] Northwest Women & Childrens Hosp, Xian, Shaanxi, Peoples R China

[14] Women & Childrens Hosp Hubei Prov, Wuhan, Hubei, Peoples R China

[15] Fujian Med Univ, Affiliated Hosp, Fujian Prov Matern & Childrens Hosp, Fuzhou, Fujian, Peoples R China

[16] Southern Med Univ, Affiliated Shenzhen Matern & Child Healthcare Hos, Guangzhou, Guangdong, Peoples R China

[17] Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Wuhan, Hubei, Peoples R China

[18] Qingdao Women & Childrens Hosp, Qingdao, Shandong, Peoples R China

[19] Guiyang Maternal & Child Hlth Care Hosp, Guiyang, Guizhou, Peoples R China

[20] Gansu Prov Matern & Child Care Hosp, Lanzhou, Gansu, Peoples R China

[21] Wenzhou Med Univ, Affiliated Hosp 2, Wenzhou, Zhejiang, Peoples R China

[22] Wenzhou Med Univ, Yuying Childrens Hosp, Wenzhou, Zhejiang, Peoples R China

[23] Anhui Med Univ, Affiliated Hosp 1, Hefei, Anhui, Peoples R China

[24] Tongji Univ, Sch Med, Shanghai Matern & Infant Hosp 1, Shanghai, Peoples R China

[25] Jiangxi Prov Childrens Hosp, Nanchang, Jiangxi, Peoples R China

[26] Xinjiang Med Univ, Affiliated Hosp 1, Urumqi, Xinjiang, Peoples R China

[27] Maternal & Child Hlth Hosp Guangxi Zhuang Autonom, Nanning, Guangxi, Peoples R China

[28] Nanjing Med Univ, Childrens Hosp, Nanjing, Jiangsu, Peoples R China

[29] Childrens Hosp Hebei Prov, Shijiazhuang, Hebei, Peoples R China

[30] Nanjing Med Univ, Affiliated Wuxi Matern & Child Hlth Hosp, Nanjing, Jiangsu, Peoples R China

[31] Shandong Univ, Qilu Childrens Hosp, Jinan, Shandong, Peoples R China

[32] Zhengzhou Univ, Childrens Hosp, Zhengzhou, Henan, Peoples R China

[33] Capital Med Univ, Beijing Childrens Hosp, Beijing, Peoples R China

[34] Cent South Univ, Xiangya Hosp 3, Changsha, Hunan, Peoples R China

来源：

PEDIATRIC INFECTIOUS DISEASE JOURNAL | 2019年 / 38卷 / 12期

基金：

加拿大健康研究院;

关键词：

early-onset sepsis; preterm; neonatal intensive care units; epidemiology; pathogens; B STREPTOCOCCAL DISEASE; STENOTROPHOMONAS-MALTOPHILIA; ACHROMOBACTER-XYLOSOXIDANS; NECROTIZING ENTEROCOLITIS; INFECTION; INFANTS; CHORIOAMNIONITIS; COLONIZATION; BURDEN; COHORT;

D O I：

10.1097/INF.0000000000002492

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: The epidemiology of early-onset sepsis (EOS) in China is poorly understood because of the paucity of high-quality data. We aimed to examine the epidemiology, pathogen distribution and neonatal outcomes of EOS among a large cohort of preterm infants in China. Methods: All infants born at Results: Among 27,532 enrolled infants, 321 (11.7 cases per 1000 admissions) infants developed EOS, and 61 (19.0%) infants died within seven days after EOS onset. The incidence of EOS among inborn infants in 18 perinatal centers was 9.7 cases per 1000 live births <34 weeks' gestation (186/19,084). The case fatality rate was 22.6% (42/186). Gram-negative bacteria were responsible for 61.7% of EOS and 82.0% of EOS-related deaths. Escherichia coli (20.3%) was the leading pathogen, followed by Coagulase-negative staphylococcus (16.5%), Achromobacter xylosoxidans (9.0%) and Klebsiella pneumoniae (8.1%). Group B streptococci infections were relatively rare (2.5%). EOS was an independent risk factor for all-cause mortality and retinopathy of prematurity. Conclusions: There is a high burden of EOS among preterm infants in China with a distinctive pathogen distribution. Longitudinal epidemiologic monitoring, further investigation of causative pathogens and development of targeted strategies for prevention and treatment of EOS are needed.

引用

页码：1236 / 1241

页数：6

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