The Predisposing Factors of Coagulase Negative Staphylococcal Bacteraemia in Neonatal Intensive Care Unit

新生兒加護病房凝固酶陰性葡萄球菌菌血症之誘發因子

黃永豐(Yung-Feng Huang) ； 謝凱生(Kai-Sheng Hsieh) ； 劉永慶(Yung-Ching Liu) ； Robert Graham Feldman

《Acta Paediatrica Taiwanica》 42卷1期 (2001/02) Pp. 22-26

https://doi.org/10.7097/APT.200102.0022

摘要

凝固酶陰性葡萄球菌是新生兒加護病房最常見血液陽性培養。如何分辨成臨床有意義的感染及污染菌一直是臨床重要課題。我們從兩家醫學中心新生兒加護病房進行前瞻性研究。試圖找出真正由凝固酶陰性葡萄球菌引起的真正敗血症相關因素，每個病例根據臨床指標及診斷區分爲感染組及污染組，在線性回歸分析結果顯示跟感染組有相關因素，有置放長導管(P=0.001)，不正常白血球數目(P=0.037)及不正常白血球型態(p=0.027)有明顯的正性相關。不正常白血球型態，是由二位資深血液科醫師判斷，超過一半培養陽性爲污染組，而且真正感染可能發生於沒有放置長導管病人。

關鍵字

凝固酶陰性葡萄球菌 ； 導管引起敗血症 ； 新生兒敗血症

並列摘要

Coagulase negative staphylococci are the commonest blood culture isolate from infants on neonatal intensive care units. The differentiation of contaminants from isolates representing true infection remains a significant clinical problem. Data from two neonatal intensive care units were collected prospectively in order to find those parameters, which best correlated with actual sepsis. Each case was assessed using clinical parameters to categorise infants into infection and contaminant groups. Logistic regression was then performed to find significant correlates. Three correlates were found, namely the presence of a long line (P=0.001), abnormal white cell count (P=0.037) and abnormal white cell morphology (P=0.027). Abnormal white cell morphology was assessed by two experienced hematologists. More than half the isolates were probable contaminants and true infection may occur in the absence of a long line in this patient group.

並列關鍵字

coagulase negative staphylococcus ； catheter-related sepsis ； neonatal sepsis ； intensive care