目的 分析新生儿无乳链球菌（B族链球菌,GBS）败血症的临床特点、围产期高危因素及预后,提高临床对GBS败血症的认识。方法 选择21例GBS败血症新生儿（收集病例时间为2018年2月—2021年11月）,采用回顾性调查法分析临床资料;对新生儿临床资料、实验室检查、影像学资料进行统计和对比,分析临床特征,同时比较患儿合并症情况及评估治疗预后结果等。结果 GBS败血症新生儿中早发型（90.48%）明显高于迟发型（9.52%）,P<0.05;GBS败血症新生儿主要症状表现为发热、发绀、气促、呻吟、抽搐等,以气促、呻吟为主;通过实验室检查,发现患儿普遍存在C反应蛋白、降钙素原、白细胞计数等指标异常情况;经头颅MRI检查提示蛛网膜下腔出血6例;X线提示新生儿吸入性综合征6例、双肺新生儿肺炎4例;部分患儿存在合并症,其中1例合并脑膜炎、3例合并蛛网膜下腔出血、4例合并黄疸、2例合并新生儿低血糖;所有患儿接受抗菌药物治疗,以青霉素、头孢他啶为主,平均住院时间（14.86±2.33）d,治愈19例（占比90.48%）、1例患儿好转后家属要求签字出院,1例家属要求转上级儿童医院。结论 新生儿无乳链球菌败血症有早发型和迟发型之分,两者的临床表现及特征有明显差异,该病病情较凶险,临床需高度重视本病的防治工作,早期诊断及时治疗干预,以提高新生儿预后。

Objective To analyze the clinical characteristics,perinatal high-risk factors and prognosis of neonatal Streptococcus agalactiae（group B Streptococcus,GBS）sepsis,and to improve the clinical understanding of Streptococcus agalactiae sepsis．Methods Twenty-one newborns with GES sepsis were selected（the cases were collected from February 2018 to November 2021）,and the clinical data were analyzed by retrospective investigation．The clinical data,laboratory examination and imaging data of newborns were summarized and compared,and the clinical characteristics were analyzed．At the same time,the complications of children were compared and the prognosis of treatment was evaluated．Results In newborns with GBS sepsis,the early-onset rate（90.48%）was significantly higher than the late-onset（9.52%）,P < 0.05．The main symptoms of newborns with GBS sepsis were shortness of breath,moaning,fever,cyanosis,convulsions,etc．Through laboratory examination,it was found that there were common abnormalities in C-reactive protein,procalcitonin,leukocyte count and other indicators in children．Transcranial MRI results showed 6 cases with subarachnoid hemorrhage;X-ray showed 6 cases with neonatal aspiration syndrome and 4 cases with both lungs neonatal pneumonia．Some children had complications,including 1 case with meningitis,3 cases with subarachnoid hemorrhage,4 cases with jaundice,and 2 cases with neonatal hypoglycemia．All children were treated with antibiotics,mainly penicillin and ceftazidime．The average hospital stay was（14.86 ± 2.33）days,and 19 cases were cured（accounting for 90.48%）．One case of the child's family member asked to sign and leave the hospital after improvement,and one case of the family member asked to be transferred to a superior children's hospital．Conclusions Neonatal Streptococcus agalactiae sepsis can be divided into early-onset and late-onset type．There are significant differences in clinical manifestations and characteristics between them．The disease is dangerous,clinical attention should be paid to the prevention and treatment of the disease,early diagnosis and timely treatment and intervention,so as to improve the prognosis of newborns．

目的 探讨无乳链球菌感染性心内膜炎的临床特点和治疗效果。方法 回顾性分析我院收治的1例无乳链球菌感染性心内膜炎合并急性肝衰竭患者的临床表现、诊疗经过及预后。结果 经过积极抗感染、血浆置换和体外循环下赘生物清除、瓣膜置换手术治疗,术后继续予抗感染、抗凝等治疗,患者脏器功能恢复良好,取得了良好的治疗效果,并顺利出院。结论 无乳链球菌感染性心内膜炎可引起急性心力衰竭、急性肝衰竭、急性肾衰竭等多脏器功能不全,合理把握手术时机和准确评估围术期风险有助于提高急危重症感染性心内膜炎患者的救治率。

Objective To explore the clinical characteristics and treatment of infective endocarditis caused by Streptococcus agalactiae．Methods Clinical data and treatment details of a patient with Streptococcus agalactiae endocarditis and acute liver failure admitted to our hospital was analyzed retrospectively．Results After strict anti-biotic therapy and plasmapheresis,the patient received the vegetative removal and valve replacement and finally successfully recovered．Conclusions The diagnosis and treatment of this case suggests that Streptococcus agalactiae infective endocarditis can cause multiple organ dysfunction such as acute heart,liver and renal failure．Optimal timing of surgery and accurate benefits-risk assessment is helpful to improve the prognosis of patients with acute and severe infective endocarditis．

目的 探讨新生儿早发型B族链球菌(GBS)败血症的临床特点,提高对本病的认识。方法 选取我院2010—2012年我院新生儿重症监护病房(NICU)收治的新生儿资料,回顾性分析GBS的临床表现、实验室检查、治疗和转归。结果 早发型GBS败血症8例,占住院患儿的6.28‰,均为足月儿,生后24小时内发病,以气促、发绀等呼吸系统症状为主,其中4例出现感染性休克表现;实验室检查提示血常规WBC:2.07~14.1×10⁹/L,＜5×10⁹/L 5例,中性粒细胞绝对值0.54~8.32×10⁹/L。胸部X线提示:肺部纹理粗乱,渗出增多。1例需机械通气辅助呼吸。青霉素联合头孢三代或万古霉素治疗有效,重症感染者需加强支持治疗。结论 应重视新生儿早发型无乳链球菌败血症早期呼吸系统症状,尽早诊断和治疗,降低病死率。

Objective To investigate the clinical features of early-on set neonatal Group B Streptococcal (GBS)septicemia in order to guide the clinical diagnosis and treatment. Methods Retrospectively analysing the clinical presentation, laboratory examination, treatment and prognosis of the 8 cases of all newborns from 2010 to 2012 in our hospital. Results The incidence of neonatal early-on set Group B Streptococcal septicemia was 6.28‰.8 cases were full-term infants in this study.Respiratory symptoms such as anhelation and cyanosis were first signs of early-on set Group B streptococcal septicemia within 24 hours after birth; 4 cases of septic shock. Results of laboratory tests included WBC:2.07~14.1×10⁹/L, in which 5 cases were ＜5×10⁹/L, N 0.54~8.32×10⁹/L. Chest X-ray: lung texture showed coarse and disorderly, leakage was increased. One case needed respiratory support with mechanical ventilation. Intravenous treatment of neonatal GBS with penicillin combined with Vancomycin was effective. Patients of serve infections should be provided supportive care. Conclusion Patients of serve early symptom of respiratory system should be paid attention. Early diagnosis and treatment should be as soon as possible to reduce fatalities.