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目的分析极早产儿晚发型细菌感染败血症的临床特征及危险因素，提出可行的防治建议。方法选取2012年2月-2024年1月本院收治的94例晚发型细菌感染败血症的极早产儿作为研究对象，分析其围产期情况、临床症状、病原菌、危险因素及治疗等情况。结果极早产儿晚发型细菌感染败血症的发生率为8.40%（94/1 119）。感染病原菌中以革兰阳性菌为主、占71.1%。Logistic回归分析提示：应用抗生素≥7 d、有创机械通气、留置中心静脉导管≥7 d及阴道分娩是极早产儿晚发型细菌感染败血症的主要危险因素，相对危险度（OR值）分别为2.787、4.243、3.033、2.174。结论极早产儿晚发型细菌感染败血症的病原菌以革兰阳性菌为主，长时间应用抗生素（≥7 d）、有创机械通气、留置中心静脉导管（≥7 d）及阴道分娩为极早产儿晚发型细菌感染败血症的高危因素。可通过采取加强围产期管理、缩短抗生素应用时间、减少有创操作的防治办法来降低极早产儿晚发型细菌感染败血症的发生率。

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Objective To investigate the clinical and laboratory characteristics of sepsis caused by different types of pathogens in preterm infants. Methods Totally 99 premature infants with sepsis treated at our hospital during May 2008 and April 2018 were analyzed. According to the results of blood culture, they were divided into gram negative bacteria group and gram-positive bacterial infection group. The clinical and laboratory results of the two groups were compared. Results The incidence of nosocomial bacterial sepsis in premature infants was 1.16% (99/8 512). Gram-positive pathogens accounted for 70.3%, with Staphylococcus epidermidis as the main pathogen (36.6%). Gram-negative pathogens accounted for 29.7%, with klebsiella pneumoniae as the main pathogen (40.0%). Compared with those in gram-positive pathogens group, the incidences of severe complications, leukocyte decline, CRP elevation, abdominal distention and thrombocytopenia in gram-negative bacteria group increased significantly (P <0.05). Compared with gram-positive pathogens group, the abandonment or mortality rate of gram-negative bacteria group was also increased significantly (P <0.05). Conclusion Gram-positive pathogens are the main pathogens causing sepsis in premature infants. Gram-negative pathogen infection is more prone to complications such as shock, central infection and abdominal distention. Laboratory tests showed leukocyte reduction and thrombocytopenia and elevated CRP. Early selection of antibiotics based on clinical and laboratory results may improve the rationality of clinical medication. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)