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目的观察分析新生儿泌尿系感染(UTI)的临床特点、病原体分布、病原体药敏及治疗效果,为新生儿泌尿系感染的临床诊治提供理论依据。方法 2014年1月至2015年12月本院新生儿病房确诊的44例UTI新生儿,新生儿UTI的诊断标准参照《4版实用新生儿学》。清洁外阴后,贴一次性无菌SNQ28型婴幼儿尿液收集器,收集标本后立即送常规检查,如果非离心尿WBC>5个/HP即行无菌导尿术收集尿液送培养+菌落计数,并行药敏试验。结论 1新生儿UTI的临床表现缺乏特异性,以全身症状为主,常缺乏局部尿路表现。2新生儿UTI以血行感染为主,常伴发败血症、肺炎等全身疾病,男孩发病率高。3新生儿UTI的诊断主要依据尿液检测,对不明原因的新生儿发热、精神萎靡或高胆红素血症患儿,应及时做尿液检查,避免漏诊或误诊。4新生儿UTI的病原菌以革兰阴性菌为主,大肠埃希菌和粪肠球菌为主要致病菌,对大部分青霉素及头孢类抗生素耐药,临床医生应参照药敏结果选择敏感抗生素治疗。
Objective To observe and analyze the clinical features, pathogen distribution, pathogen sensitivity and therapeutic effect of neonatal urinary tract infection (UTI), and to provide a theoretical basis for clinical diagnosis and treatment of neonatal urinary tract infection. Methods From January 2014 to December 2015, 44 newborns diagnosed as neonates with newborns in our hospital were enrolled. The diagnostic criteria of neonatal UTI were referred to “Practical Neonatology of Version 4”. After cleaning the vulva, disposable sterile SNQ28 infants urine collector, collect the specimens immediately after the routine examination, if the non-centrifugal urine WBC> 5 / HP that is aseptic catheterization to send urine to send culture + colony count , Parallel drug sensitivity test. Conclusion 1 The clinical manifestations of neonatal Lack of lack of specificity to systemic symptoms, often lack the performance of local urinary tract. 2 neonatal UTI to blood-based infection, often accompanied by sepsis, pneumonia and other systemic diseases, high incidence of boys. 3 The diagnosis of neonatal UTI is mainly based on urine testing, neonatal fever of unknown reason, apathetic or hyperbilirubinemia in children, urine should be promptly done to avoid misdiagnosis or misdiagnosis. 4 neonatal UTI pathogens mainly Gram-negative bacteria, Escherichia coli and Enterococcus faecalis as the main pathogens, the majority of penicillin and cephalosporin antibiotics, clinicians should refer to drug susceptibility results of the selection of sensitive antibiotics .