Journal of Developmental Medicine(Electronic Version)  2021, Vol. 9 Issue (3): 194-199 DOI: 10.3969/j.issn.2095-5340.2021.03.006 |
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| The value of placental microbial detection in diagnosis and treatment of neonatal early onset sepsis |
| Li Pingping, Lin Rong, Lai Jidong, et al
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Department of Neonatology, Xiamen Key Laboratory of Perinatal-Neonatal Infection, Women and Children's Hospital, School of Medicine, Xiamen University,Fujian, Xiamen 361001, China)
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Abstract 【Abstract】 Objective To analyze placental microbial colonization, explore the value of placental
swabs culture in diagnosis and treatment of neonatal early onset sepsis (EOS), and provide reference for
clinical rational drug use. Methods A total of 858 neonates delivered from pregnant women with positive placental swabs culture between May 2015 and May 2020 were enrolled. A 1 ∶ 4 matched case control study was carried out. The EOS group (n=64) delivered from pregnant women with positive placental swabs culture as the case group, and the non EOS group (n=256) delivered from pregnant women with positive placentals wabs culture were selected as the control group. Analyze the distribution of pathogenic bacteria and the results of drug sensitivity test for pathogens in placental swab culture, and the relationship between positive outcome of placenta swabs culture and the occurrence of EOS. The clinical date and perinatal risk factors of neonates in the two groups were analyzed. Results A total of 858 (9.0%) pregnant women obtained positive placental swabs culture during this study period, with 13 pathogens identified. Among these 858 cases, 295 cases were part of Gram-positive bacteria (34.4%), 504 cases of Gram-negative bacteria (58.7%), 53 cases of fungi (6.2%) and 6 cases of mixed bacteria (0.7%). The top three pathogens of placenta swabs culture were Escherichia (E.coli) accounting for 51.6%, Enterococcus accounting for 16.3%, and group B streptococcus (GBS) accounting for 10.4%. There were no statistically significant differences in age, birth weight, gender, and delivery type between EOS group and non-EOS group (P>0.05). The top three pathogens in EOS group were E.coli (50.0%), Entero- coccus (20.3%), and GBS (14.1%). The sensitivity rates of E.coli strains to piperacillin tazobactam and meropenem were high (98.0%, 99.8% respectively). The sensitivity rate for cefotaxime was 76.1%. Around 63.3% of E.coli strains were resistant to ampicillin. The sensitivity rate of Enterococcus to ampicillin and vancomycin was as high as 100%. Totally 100% of GBS strains were sensitive to penicillin and vancomycin, and 63.0% were resistant to erythromycin. There was no significant difference between positive outcome of placenta swabs culture and the occurrence of EOS (P>0.05). The incidence of GBS-EOS with placental GBS colonization was higher than that of E.coli and Enterococcus. Chorioamnionitis (P=0.001, OR=2.503, 95%CI: 1.47-4.27) was independent risk factors for concurrent EOS
in positive placental swabs culture. Conclusion Although there is no significant correlation between
positive placental swabs culture and the occurrence of EOS, timely evaluation and early rational antibiotics
usage should be given when neonates' mother presenting with chorioamnionitis which is a risk factor for EOS.
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Received: 18 February 2021
Published: 26 May 2021
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