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題 名 | Staphylococcus capitis Bacteremia of Very Low Birth Weight Premature Infants at Neonatal Intensive Care Units: Clinical Significance and Antimicrobial Susceptibility=新生兒加護中心極低體重早產兒Staphylococcus capitis菌血症:臨床意義和抗生素感受性 |
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作 者 | 王世敏; 劉清泉; 曾慧菀; 楊燿榮; 林其和; 黃愛惠; 吳怡慧; | 書刊名 | 微免與感染雜誌 |
卷 期 | 32:1 1999.03[民88.03] |
頁 次 | 頁26-32 |
分類號 | 417.5171 |
關鍵詞 | 極低體重早產兒; 感染; CNS; Staphylococcus capitis; Bacteremia; NICU; VLBW; |
語 文 | 英文(English) |
中文摘要 | 凝固汛陰性葡萄球菌通常可自重病的新生兒血液培養分離出,其中有關於 Staphylo- coccus capitis 造成感染則很少報導。自1995年至1997年,在某醫學中心新生 兒加護中心從極低體重早產兒236次陽性血液培養分離出147株(62%)凝固訊陰性葡 萄球菌,包括27株的S. capitis。而在這些S. capitis 菌血症中,17次被診斷為感 染,另10次則為非感染。發生S. capitis 感染和長期住院(52±17.6天vs.28± 18.5天,p=0.003)及全靜脈營養給予(46±17.4天vs.22±19.1天,p=0.006) 有關。主要臨床表現有呼吸暫停、心跳變慢、體溫不穩及活力變差,其中一例病患 合併腦膜炎,經由適當的抗生素治療所有的病人均存活。S. capitis感染和經皮放 置中央靜脈導管的時間,並無統計上的差異,此外培養結果並未証實任何導管相關 性之感染。所以在S. capitis 菌血症的病人並不建議常規地移除中央靜脈導管。S. capitis 的多重抗生素抗藥性盛行率為97%,所有菌株都對oxacillin, erythromycin,和clindamycin有抗藥性,但對ampcillin/sulbactam,vancomycin 和teicoplanin均具感受性。找出多重抗生素抗藥性的S. capitis 以給予病人 適當抗生素治療是相當重要的。此外在新生兒加護中心極低體重早產兒S. capitis 怠染應是造成院內感染突發之可能原因之一。 |
英文摘要 | Coagulase-negative staphylococci (CNS) are frequently isolated from blood cultures in critically ill neonates. However, Staphylococcus capitis is rarely reported as a pathogen in human beings. From January, 1995 to December, 1997 at a tertiary care neonatal intensive care unit (NICU), a total of 147(62%) CNS isolates were detected from 236 positive blood cultures, including 27 isolates of S. capitis. Among the S. capitis bacteremia, 17 isolates were judged to be infections as opposed to 10 of the noninfection cultures. The occurrence of S. capitis infection was correlated with long hospital stay(52 ± 17.6 days vs. 28 ± 18.5 days, p=0.003) and total parenteral nutrition administration (46 ± 17.4 days vs. 22 ± 19.1 days, p=0.006). Apnea, bradycardia, temperature instability and poor activity were the predominant clinical features. Among the 17 episodes of bacteremia, one patient had complicated septic meningitis. There is no statistical significance between S. capitis infection and the duration of a central venous catheter placement (37 ± 17.5 days vs. 26 ± 19.5 days, p=0.165). No catheter related infection was proven. Removal of a percutaneous central venous catheter routinely in patients with S. capitis bacteremia is not recommended. All the patients survived after antibiotic treatment. The prevalence rate of multiple resistant S. capitis was 94%. All isolates were resistant to oxacillin, erythromycin and clindamycin but susceptible to ampicillin/sulbactam, vancomycin and teicoplanin. Empiric therapy for S. capitis infection in NICU with ampicillin/sulbactam is therefore recommended. It is important to detect S. capitis which has a high degree of antibiotic resistance in order to treat the patient correctly. S. capitis should be included as etiology and the possibility of nosocomial outbreak in very low birth weight (VLBW) premature infants at NICU. |
本系統中英文摘要資訊取自各篇刊載內容。