Volume 20 Issue 8
Aug.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(8): 1357-1359
LU Yan, PAN Shan-shan. Analysis of the clinical characteristics and stool pathogen of necrotising enterocolitis in preterm neonates[J]. Chinese Journal of General Practice, 2022, 20(8): 1357-1359. doi: 10.16766/j.cnki.issn.1674-4152.002596
Citation: LU Yan, PAN Shan-shan. Analysis of the clinical characteristics and stool pathogen of necrotising enterocolitis in preterm neonates[J]. Chinese Journal of General Practice, 2022, 20(8): 1357-1359. doi: 10.16766/j.cnki.issn.1674-4152.002596
shu

Analysis of the clinical characteristics and stool pathogen of necrotising enterocolitis in preterm neonates

doi: 10.16766/j.cnki.issn.1674-4152.002596
  • 1.

    Department of Neonatology, Affiliated Hangzhou First People' s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China

Funds:

 2021PY057

  • Received Date: 2021-01-17
    Abstract
  •   Objective  To investigate the clinical characteristics of neonatal necrotising enterocolitis (NEC) in preterm infants.  Methods  A retrospective study was conducted from January 2017 to November 2020 at the Affiliated Hangzhou First People ' s Hospital, Zhejiang University School of Medicine. NEC was defined according to Bell ' s staging criteria.  Results  Fifty-nine neonates were included in the study. Amongst them, 22 (37.3%) cases developed stage Ⅰ, and 37 cases (62.7%) cases developed stage Ⅱ or Ⅲ. Analysis of the time of NEC onset showed that the median age of NEC onset was 14.0 (13.0, 18.0) day. The gestational age was (30.7±2.7) weeks, and the birth weight was (1 493.9±460.3) g. There were 36 (61.0%) male cases and 23 (39.0%) female cases. The most common clinical presentations were bloody stools (79.7%, 47/59 cases), gastric residuals (78.0%, 46/59), absent bowel sounds (57.6%, 34/59 cases) and abdominal distension (52.5%, 31/59 cases). Compared with the stage Ⅰ group, the stage Ⅱ or Ⅲ group had significantly higher incidence rates of abdominal distension, poor response, absent bowel sound, bradycardia, greater white blood cell count (< 4×109/L) and CRP≥50 mg/L, P < 0.05. The positive rate of stool culture was 65.5% (36/55 cases), mainly including 29.1% Klebsiella pneumoniae (16/55 cases), 20.0% Enterococcus faecium (11/55 cases) and 12.7% Escherichia coli (7/55 cases). The positive rate of blood culture was 15.1% (8/53 cases), including 3.8% Escherichia coli (2/53 cases) and 3.8% Klebsiella pneumoniae (2/53 cases). The incidence of surgical NEC was 20.3% (12/59 cases). The mortality rate of NEC was 16.9% (10/59 cases).  Conclusion  NEC mainly affects preterm neonates with gestational age of 28-32 weeks and birth weight of 1 000-1 950 g. Gastrointestinal symptoms and signs are prominent. There are significant differences in clinical manifestations and laboratory parameters between neonates in the stage Ⅰ group and those in the stage Ⅱ or Ⅲ group. The positive rate of stool sample culture is high in NEC neonates. Monitoring of intestinal pathogen may be helpful to guide clinical therapy.

     

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