A ten year, multicentre study of coagulase negative staphylococcal infections in Australasian neonatal units

被引:144
作者
Isaacs, D [1 ]
机构
[1] Childrens Hosp, Dept Immunol & Infect Dis, Westmead, NSW 2145, Australia
来源
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION | 2003年 / 88卷 / 02期
关键词
D O I
10.1136/fn.88.2.F89
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To study late onset systemic infections with coagulase negative staphylococci. Methods: Prospective longitudinal study of coagulase negative staphylococcal infection in 18 Australasian neonatal nurseries. Results: From 1991 to 2000 inclusive, there were 1281 cases of coagulase negative staphylococcal (CoNS) sepsis, comprising 57.1% of all late onset infections. The male/female ratio was 1.27:1 (p < 0.05). The incidence of CoNS sepsis was 3.46 episodes per 1000 live births. Most infected babies (71%) were 24-29 weeks gestation at birth (mode 26 weeks). The first positive culture was day 7-14 in 49% of babies (mode 10 days). Five cases of meningitis were reported, an incidence of 0.4% of all CoNS infections. Twenty nine babies (2.3%) had concurrent necrotising enterocolitis and CoNS septicaemia. Four babies (0.3%) died from CoNS infection, but CoNS infection possibly contributed to the death of an additional 20 babies (1.6%). The mortality directly attributable to CoNS infection was significantly lower than that from late onset infections with Staphylococcus aureus (13.1%; relative risk (RR) = 36.1 (95% confidence interval (Cl) 13.0 to 100.2) or with Gram negative bacilli (14.2%; RR = 45.5 (95% Cl 16.8 to 123.3)). Conclusions: CoNS are currently responsible for most late onset neonatal infections. Most infected babies are < 30 weeks gestation at birth, and usually present between 7 and 14 days of age. CoNS infections may be associated with necrotising enterocolitis, although causality is unproven. Neonatal CoNS infections are relatively benign: meningitis is rare and mortality low compared with infection from other organisms. Over-vigorous attempts to reduce the incidence of CoNS infections using prophylactic antibiotics are not advisable.
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收藏
页码:F89 / F93
页数:5
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