新生儿无乳链球菌败血症合并脑膜炎12例临床分析-临床儿科杂志.pdfVIP

临床儿科杂志第 34 卷第 3 期 2016 年 3 月J Clin Pediatr Vol.34 No.3 Mar. 2016 · 181 · doi:10.3969 j.issn.1000-3606.2016.03.006 新生儿无乳链球菌败血症合并脑膜炎 12 例临床分析 杨欢欢 李 菁 上海交通大学医学院附属上海儿童医学中心（上海　200127 ） 摘要： 目的 方法 探讨无乳链球菌（GBS ）败血症合并脑膜炎新生儿的临床表现、治疗及预后情况。 回顾性分析 结果 2012 年1月至2015 年5 月收治的12例无乳链球菌脑膜炎新生儿的临床资料。 12 例患儿中，男女各6例，均为足月儿， 早发型4 例、晚发型8例，顺产7例、剖宫产5例，母亲均无明显感染病史，亦未行常规GBS 筛查。新生儿血降钙素原均升高。 头颅磁共振（MRI ）可见脑膜强化，5 例硬膜下积液，3 例脑实质受累。1例单用青霉素，1例应用美罗培南之后降阶梯单用 青霉素效果良好，大部分患儿需联合用药。随访20~29 个月，1例语言发育落后，2 例运动发育落后，其余9 例发育正常。结 论 新生儿无乳链球菌败血症合并脑膜炎病情危重，需及时应用敏感抗生素，必要时联合用药。建议完善产前筛查。 关键词： 无乳链球菌； 败血症； 脑膜炎； 新生儿 Clinical and prognostic analysis of sepsis caused by Streptococcus agalactiae combined with purulent meningitis in 12 neonates YANG Huanhuan, LI Jing (Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China) Abstract: Objective To investigate the clinical manifestations, treatment and prognosis of sepsis caused by Streptococcus agalactiae combined with purulent meningitis in neonates. Methods Clinical data of 12 neonates with purulent meningitis caused by Streptococcus agalactiae were analyzed retrospectively from January 2012 to May 2015. Results In 12 full term neonates (6 males and 6 females) , there were 4 early onset cases and 8 late onset cases; 7 cases of vaginal delivery and 5 cases of cesarean section. All of the mothers had no history of infections, and also no routine screening for group B streptococcus. The serum levels of procalcitonin were eleva