新生儿无乳链球菌败血症8例临床分析并文献复习

摘要

目的：探讨新生儿无乳链球菌（GBS）败血症的临床特点并进行相关文献复习。方法：回顾性分析2012-2014年青岛市妇女儿童医院新生儿重症监护室住院的8例GBS败血症患儿的一般资料、临床特征、影像学检查结果、治疗及转归。结果：8例GBS败血症患儿4例为早发型，4例为晚发型；1例早产儿，7例足月顺产儿；7例发热伴不同程度的神经系统异常症状，1例无异常症状及体征，血培养均提示为青霉素及万古霉素敏感；5例合并化脓性脑膜炎，1例头颅MRI出现脑软化灶，2例蛛网膜下腔出血；影像学检查：2例MRI异常，4例正常，2例未做。随访至今，2例死亡，1例运动发育落后，5例生长发育正常。结论：新生儿GBS败血症死亡率、致残率高。强有力、足量、足疗程抗感染外，产前产时GBS筛查和预防性应用抗生素应积极尽早开展，以减少后遗症发生。%Objective:To explore clinical characteristics of neonatal group B streptococcal septicemia and do a literature review. Method:The general information,clinical features,imaging findings,treatment and prognosis of 8 neonates with GBS septicemia admitted to NICU of this hospital from 2012 to 2014 were analyzed retrospectively. Result:Among the 8 cases,4 cases were early-onset neonatal sepsis,4 cases were late-onset. 1 case was premature,7 cases were full-term. 7 cases had fever with different degrees of neurological abnormalities,1 had no abnormal symptoms and signs. All the GBS strains were sensitive to penicillin and vancomycin. 5 cases who had purulent meningitis were implemented the brain magnetic resonance imaging(MRI)before discharge,with the consequences of encephalodialysis in 1 case,subarachnoid hemorrhage in 2 cases.Imageological examination,2 cases of abnormal MRI 4 cases of normal and 2 cases not done. So far,the follow-up demonstrated that 2 neonates died,1 case had retardation,the other 5 cases were normal. Conclusion:Neonatal GBS septicemia had a high mortality and morbidity. It’s very necessary to develop the antepartum and intrapartum screening for GBS and the intrapartum antibiotic prophylaxis to reduce incidence of complications in addition to the strong,enough,full course of anti-infection treatment.