Etiology of neonatal infection related to premature rupture of membranes / 中华全科医师杂志

ABSTRACT

Objective To investigate the common pathogens in neonatal infections with premature rupture of membranes (PROM).Methods From May 2007 to November 2010,16 356 neonates who were admitted to Bayi Children's Hospital were assigned to this study. The related clinical and laboratory information were recorded,including PROM and its time of duration,results of blood culture and other clinical data.Results A total of 3432 patients accompanyed with PROM among 16 356 infants (21.0％).There were 1060 full-term neonates (30.9％ ) and 2372 premature infants (69.1％ ) among 3432 PROM cases.The incidence of infectious disease was 35.8％ ( 1227/3432 ) in infants with PROM.The overall positive rate of blood culture was 7.6％ ( 260/3432 ) in infants with PROM10.5％ ( 111/1060 ) in term infants and 6.3％ (149/2372) in premature infants ( x2 =18.370,P =0.000).The common pathogenic organisms were gram positive ( G + ) cocci ( 58.5％ ) and gram negative ( G- ) bacilli ( 33.8％ ) ( x2 =31.695,P =0.000 ).The most common organisms included Staphylococcus epidermidis,Staphylococcus homis,Klebsiella pneumoniae,Escherichia coli and Hemolytic staphylococci,accounting for 75.8％ of the total blood culture positive patients.Fungal infection accounted for 7.7％ of the total infectious diseases,which was all in premature infants. The blood culture-positive rate in patients with PROM duration ＜24 h,≥24 hand ≥72 h were 7.7％ ( 119/1544),7.2％ (99/1382),and 9.6％ (42/439) ( x2 =2.701,P =0.259 ),respectively.Conclusions G + coccus is the most common pathogenic bacteria of neonatal infection related to PROM,followed by G- bacillus.Fungi are detected mainly in premature infants.The blood culture-positive rate may not increase with the extension of time of PROM.