早产儿与足月儿败血症病原菌十年变迁研宄分析陈志伟（广东省湛江市徐闻县人民医院检验科524100）【摘要】目的研宄早产儿与足月儿败血症近十年病原菌的感染情况，为临床治疗新生儿败血症提供参考依据。方法对2003年1月-2013年1月在木院新生儿科确诊为败血症的256例患儿按胎龄分为早产组与足月组，分别对二组分析病原菌的感染情况，了解二组病原菌感染的差异及前五年与后五年病原菌的变迁情况。结果早产组凝固酶阴性葡萄球菌（CNS）感染率为38.89%，足月组金黄色葡萄球菌感染率为39.15%，二组感染率差异比较有统计学意义（P<0.05）;早产组败血症前五年与后五年排在首位的是大肠埃希菌与CNS,其感染率分别为28.57%与56.25%,其前后五年感染率相比较差异有统计学意义（P<0.05）;足月组败血症前五年与后五年排在首位的是金黄色葡萄球菌及CNS与金黄色葡萄球菌，感染率分别为44.30%、34.49%与34.48%,其中后五年CNS感染率明显比前五年的高，二者相比较差异有统计学意义（P<0.05）。结论新生儿败血症中，早产儿感染的病原菌首位为CNS，足月儿感染的病原菌首位为金黄色葡萄球菌;近五年来，早产儿败血症病原菌中大肠埃希菌明显减少，CNS感染明显增加；足月儿败血症病原菌金黄色葡萄球菌仍占首位，似CNS感染率明显增加。【关键词】新生儿败血症病原菌变迁研究【中图分类号】R722【文献标识码】A【文章编号】2095-1752（2013）24-0083-02ChangesonpathogenofneonatalsepsisinpretermandfullterminfantsintenyearsCHENZhi-wei,clinicallaboratorydepartment,xuwenhospital,zhanjian524100,china【Abstract】ObjectiveTostudythepathogeninfectionstatusinpretermandfullterminfantsofneonatalsepsisnearlyadecade,andprovidereferencefortheclinicaltreatmentofneonatalsepsis.MethodInJanuary2003〜January2013inourhospital,whodiagnosedneonatalsepsisaccordingtogestationalagewasdividedintopretermandfull-termgroup,totalof256cases,analysethepathogeninfectionstatusontwogroupsrespectively,understandthedifferencesbetweenthetwogroupofpathogeninfectionandfiveyearsbeforeandfiveyearsafterthechangesofpathogenicbacteria.ResultThepretermgroupofcoagulasenegativestaphylococcus(CNS)infectionratewas38.89%,full-termgroupofstaphylococcusaureusinfectionratewas39.15%,twogroupsofinfectionratedifferencehavestatisticalsignificance(P<0.05);Pretermgroupsepsisfiveyearsbeforeandfiveyearsafterthefirstofthelistise.coliandtheCNS,theinfectionrateswere28.57%and28.57%,theinfectionrateforfiveyearsbeforeandaftercomparisondifferencewasstatisticallysignificant(P<0.05);full-termgroupfiveyearsbeforeandfiveyearsafterthefirstofthelistiswithstaphylococcusaureus,staphylococcusaureusandCNS,whichinfectionrateswere44.30%,34.49%and44.30%respectively,CNSinfectionrateinfiveyearsafterwassignificantlyhigherthaninthepastfiveyears,andcomparedthedifferencewasstatisticallysignificant(P<0.05).ConclusionIntheneonatalsepticemia,prematurebabiesfirstforCNSinfectionofpathogenicbacteria,andfulltermfirstforstaphylococcusaureusinfectionofpathogenicbacteria;Nearlyfiveyears,prematuresepsisinpathogenicbacteriae.colidecreasedsignificantly,CNSinfectionincreasedsignificantly;Fulltermpathogensstaphylococcusaureussepsisstillaccountforthefirstplace,butCNSinfectionrateincreasedsignificantly.【keywords］NeonatalsepsisPathogenicbacteriaChangeresearch新生儿败血症指新生儿期细菌或真菌侵入血循环并在其中生长繁殖，产生毒素所造成的全身性感染，是新生儿期间感染性疾病中的严重疾病，其发生率占活产儿的0.1%〜1%,病死率为13%〜50%,长期住院者可高达30%［1］。据李刚［2】等的研究，新生儿败血症病原菌主要为葡萄球菌，其次为大肠埃希菌，但其每十年就会有所变动II存在地区差异［3】；Yalaz［4］等的研究结果也表明，20世纪30〜40年...