实证医学病例讨论报告-Soup.io.ppt

Method – types of intervention The 200 infants on whom observations were made during the trial were therefore allotted to one of 4 groups as follows： Group A - infants delivered 24 hours or more after rupture of the membranes but given no antibiotics. Group B - infants delivered 24 hours or more after rupture of the membranes and given prophylactic antibiotics. Group C - infants delivered 24 hours or more after rupture of the membranes but considered to be at particular risk and therefore given prophylactic antibiotics. Group D - 100 control infants thought to be completely well after normal deliveries and given no antibiotics. The distribution of the cases is given in Table I. The given antibiotics are ampicillin and cloxacillin Risk Maternal factors - amnionitis Obstetric complications - caesarian section, Ventouse or forceps delivery, prolapsed cord, fetal distress. Pediatric complications (intra- or post-partum) - endotracheal intubation, low Apgar at 5 minutes, umbilical catheterization, subdural taps, clinical evidence of infection. Method - types of intervention No No Yes Yes Method - types of outcome measures Bacteriological investigations Swabs of amnion, umbilicus, nasopharynx, eyes, urine and feces specimens. All cultures were incubated overnight at 37℃. Neonatal clinical infections Method - types of outcome measures Bacteriological investigations Swabs of amnion, umbilicus, nasopharynx, eyes, urine and feces specimens. All cultures were incubated overnight at 37℃. Neonatal clinical infections Result - Bacteriological investigations 194 infants：no evidence of significant bacterial colonization. 6 cases：significant surface bacterial colonization had occurred before or during delivery Result - Neonatal infections Six incidents of infection were recorded, 3 occurring in the study series and 3 in the control series. No No Yes Yes Result - Neonatal infections In contrast, the incidence of clinical fungal infection (oral and perian