Clinical characteristics analysis of neonatal acute kidney injury with positive blood culture
Objective To explore the clinical features of neonatal acute kidney injury(AKI)with positive blood culture and to analyze the etiological characteristics.Methods The clinical data of newborns with positive blood culture from January 2017 to December 2018 were retrospectively analyzed.According to the improved KDIGO standard of neonatal AKI,all neonates were divided into AKI group and non AKI(NAKI)group.And then according to the gestational age,they were divided into premature infant group and full-term infant group.The distribution of pathogenic bacteria was an-alyzed retrospectively.Results In the 128 infants,34 had AKI and the incidence rate was 26.6％.Compared with NA-KI group,the number of case in AKI group were higher with abnormal white blood cell count,decreased platelet count and increased c-reactive protein.Also,the incidence of septic shock,disseminated intravascular coagulation(DIC)and multiple organ dysfunction syndrome(MODS)was higher,there were statistically differences(P＜0.05).A total of 11 pathogenic bacteria were detected,Gram-negative bacilli(59 strains,46.1％)were the primary microorganisms,the rest were Gram-positive cocci(49 strains,38.3％)and fungus(18 strains,14.1％).The incidence of AKI was calculated according to different types of pathogenic bacteria,it was found that the incidence of AKI of newborns with blood culture of staphylococcus was lower than that of others(P＜0.05).Kleb-siella pneumoniae was the predominant isolate followed by fungus in premature infant,there was no statistically significant difference in the incidence of AKI of the two groups(P＞0.05).The common pathogenic bacteria were Staphylococcus and Klebsiella pneumonia in full-term infant,AKI's incidence of staphylococcal was lower than that of other pathogens(P＜0.05).Conclusion The incidence of septic shock,DIC and MODS in AKI group was higher than that in NAKI group.Gram-negative bacilli(59 strains,46.1％)were the primary microorganisms.The incidence of AKI of newborns with blood culture of Staphylococcus was lower than that of other pathogens.
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