| 摘要: |
| 目的:探讨新生儿败血症的病原学特征、围生期危险因素,并构建多重耐药(MDR)风险预测模型。 方法:分析首都医科 大学附属北京天坛医院 2019 年 9 月-2025 年 5 月收治的 130 例新生儿败血症患儿的临床资料,采用多因素 logistic 回归分析 MDR 感染的独立危险因素,并构建预测模型及绘制 ROC 曲线。 结果:病原菌以革兰阳性菌为主,凝固酶阴性葡萄球菌对青霉 素、红霉素耐药率高。 抗菌药物使用时间>10 d、住院时间≥14 d、母亲阴道炎及并发脑膜炎是 MDR 感染的独立危险因素(P< 0. 05)。 预测模型的 AUC 为 0. 812,最佳截断值为 0. 41,灵敏度 78. 6%,特异度 74. 3%。 结论:新生儿败血症病原菌以革兰阳性 菌为主,MDR 感染风险与抗菌药物使用时间及围生期因素密切相关。 |
| 关键词: 新生儿败血症 病原菌分布 耐药性 围生期 多因素分析 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.06.007 |
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| 基金项目:北京市丰台区临床重点专科项目,丰卫健发〔2024〕108 号 |
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| Etiological Characteristics and Perinatal Risk Factors of Neonatal Sepsis and Strategies for Prevention and Treatment of Multidrug Resistant Organism Infection |
| Niu Manman1 , Song Jingyuan1 , Qi Yujie2 , Guo Guo1 |
| (1. Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; 2. Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China) |
| Abstract: |
| Objective: To investigate the etiological characteristics and perinatal risk factors of neonatal sepsis and establish a predictive model for multidrug resistance (MDR). Methods: Clinical data from 130 infants with sepsis admitted into Beijing Tiantan Hospital, Capital Medical University from Sept. 2019 and May 2025 were analyzed. Multivariate logistic regression analysis identified independent risk factors for MDR infection, followed by model development and ROC curve generation. Results: Gram-positive bacteria predominated among pathogens, with high rates of penicillin and erythromycin resistance observed in coagulase-negative Staphylococcus species. Independent risk factors for MDR infection included >10 d of antimicrobial use, ⩾14 d of hospital length of stay, maternal vaginitis, and concurrent meningitis (P<0. 05). The AUC of predictive model was 0. 812, with an optimal cutoff value of 0. 41, yielding a sensitivity of 78. 6% and a specificity of 74. 3%. Conclusion: Gram-positive bacteria predominate as pathogens in neonatal sepsis, and the risk of MDR infection is closely associated with the duration of antimicrobial use and perinatal factors. |
| Key words: neonatal sepsis pathogen distribution antimicrobial resistance perinatal period multivariate analysis |
