Overwhelming Infections in the Newborn and Early Infancy

新生兒及幼嬰之重度細菌感染症

王作仁(Tso-Ren Wang) ； 黃富源(Fu-Yuan Huang) ； 李慶雲(Chin-Yun Lee)

《Acta Paediatrica Sinica》 14卷2期 (1973/06) Pp. 55-64

摘要

自民國57年1月起至60年12月止，4年之間因重度細菌感染，而住進國立臺灣大學醫學院附設醫院小兒科的三個月以下初生嬰兒共有108例，佔同一時期同年紀住院總數(1407人)的71.7%。其中男嬰有73例，女嬰35例，男女之比約爲2比1。死亡者計29例，佔26.8%，死亡率無男女性別之差別。各種嚴重感染包括敗血症、蜂窩組織炎、化膿性腦膜炎、泌尿系統感染、頭部血瘤感染、膿胸及臍帶炎等。依年度而分，則病例有逐年增加之趨勢。臨床上有各式各樣的症狀，最常見的是發燒或體溫不穩定、不安、腹部膨脹、呼吸急促等。培養出的病菌中以金黃色葡萄球菌爲最常見，約佔有半數之多，其次爲革蘭氏陰性的腸內病菌。所以對於一個相當懷疑有嚴重細菌感染之初生兒，最初宜使用針對該兩類細菌最有效之抗生素，俟培養及敏感度試驗結果報告後，再加以調整配合較爲安全。文中會對於新生兒較易發嚴重細菌性感染之原因加以討論；並主張對於嚴重感染之診斷宜愼重其事，力求病史，臨床觀察及實驗診斷之綜合判斷；最後，對於一些結果未殝理想認爲仍有值得改進之餘地。

並列摘要

A review of 108 cases of overwhelming infections occurred in the newborn and early infancy at the Pediatric Department of the National Taiwan University Hospital from January 1968 to December 1971 is presented. They included cases of septicemia, cellulites or pustules, purulent meningitis, urinary tract infections, infected cephalhematoma, pneumonia with pyothorax and omphalitis. During that period, the overall incidence of overwhelming infections increased. Among those overwhelming infections, staphylococcus aureus was the leading pathogen. The overall mortality rate during that period was 26.8%, and there was no significant sex difference. Reviewing of the bacterial cultures and bacterial sensitivities to the various antibiotics is also presented.