Clinical analysis of neonatal necrotizing enterocolitis complicated septicemia

Abstract:

Objective：To study the incidence，risk factors and pathogens of neonatal necrotizing enterocolitis（NEC） complicated sep－ticemia. Methods：Clinical features were analyzed retrospectively in 277 newborns suffering from NEC. Pathogens results of blood and peritoneal fluid culture samples were analyzed in infants with NEC complicated septicemia，who were medically treated in the Chil－dren’s Hospital of Chongqing Medical University from July 2000 to February 2013. Results：Incidence of NEC complicated septicemia was 28.5%（79/277），higher in preterm group（P=0.049）. Among 79 neonates，there were 32 preterm infants（40.5%）. Average gesta－tional age and birth weight were （36.62±3.26） weeks and （2 551.06±737.90） grams，respectively. Average day of onset was （10.30 ± 12.18） d，of which the preterm group was （12.90±16.23） d；the smaller the gestational age，the later the onset time. Main prenatal factors were infectious diseases，premature rupture of membranes and amniotic fluid abnormalities. Chief clinical manifestations were abdominal distension，vomiting，apathetic and hyperbilirubinemia. The other accompaniments or complications were pneumonia，in－testinal perforation and peritonitis. Seventy two cases（91.1%） met the clinical diagnostic criteria in blood analysis. Finally，19 infants（24.1%） were cured，28 infants（35.4%） were improved，while 9 infants（11.4%） given up and 23 infants（29.1%） died. Most infants belonged to stage Ⅲ（49 cases，62.2%）. Out of 72 blood and peritoneal samples：13 kinds，38 stains were detected. Positive rates of blood and peritoneal culture were 46.9% and 66.7%，respectively. Escherichia coli（29.1%） and Klebsiella pneumoniae（29.1%） were the most common pathogens. Conclusions：Infants with NEC（stageⅡ or Ⅲ） are prone to complicate with septicemia. Once definite diagnosis of NEC has been made，blood cultures should be routinely done. Anaerobic cultures should be emphasized on and labora－torial index should be monitored regularly so as to reduce the possibility of occurrence of gut-derived septicemia.