摘要
目的探讨新生儿重症监护室(NICU)低出生体重儿直肠细菌定植的特点及不同喂养方式对定植的影响。方法选择NICU患儿165例为研究对象,根据喂养方式分为肠外营养组50例、人工喂养组68例和母乳喂养组47例。纳入研究后2周应用直肠拭子取样,将标本接种于血液琼脂平板、麦康凯琼脂培养基和沙氏葡萄糖琼脂培养基。细菌鉴定采用Vitek Two全自动鉴定仪。结果与母乳喂养组和人工喂养组相比,肠外营养组的胎龄较小、出生体重较轻、产前应用类固醇激素的比例较高。86.7%(143/165)的患儿有革兰阳性菌定植,60.6%(100/165)的患儿有革兰阴性菌定植。肠外营养组革兰阳性菌、革兰阴性菌定植率均低于人工喂养组和母乳喂养组(均P<0.017),母乳喂养组溶血葡萄球菌定植率低于肠外营养组和人工喂养组(均P<0.017)。多因素logistic回归分析显示,胎龄、出生体重、剖宫产、喂养方式是直肠革兰阳性菌和革兰阴性菌定植的独立危险因素。结论母乳喂养或人工喂养较肠外营养有更多的直肠细菌定植,其临床意义需要大规模、多中心的研究进一步证实。
Objective To investigate the effect of feeding patterns on rectal colonization in low birth weight infants in neonatal intensive care unit（NICU）. Methods One hundred sixty five infants admitted in NICU were enrolled in the study. The infants were divided into 3 groups based on feeding patterns： parenteral nutrition group（n=50）, artificial feeding group（n=68）and breastfeeding group（n=47）. The samples were obtained by rectal swabs 2 weeks after the enrollment, then inoculated on blood agar, Mac Conkey agar and Sabouraud dextrose agar. The bacteria were identified by Vitek Two automatic identification system. Results Compared with the breastfeeding group and artificial feeding group, the parenteral nutrition group had a less gestational age, birth weight and a higher proportion of pueperal steroids use. The majority of infants（86.7%, 143/165） were colonized with gram- positive bacteria, and approximately 60.6%（100/165） of infants were colonized with gram- negative bacteria.The parenteral nutrition group had a lower gram- positive and gram- negative bacteria colonization rate than the artificial feeding group and breastfeeding group（all P〈0.017）. The breastfeeding group had a lower colonization rate of hemolytic staphylococcus than the parenteral nutrition group and the artificial feeding group（all P〈0.017）. Multivariate logistic regression analysis showed that gestational age, birth weight, cesarean section and feeding patterns were the independent risk factors for rectum colonization of gram- positive and gram- negative bacteria. Conclusion Breastfeeding or artificial feeding can lead to more rectal colonization compared with parenteral nutrition, and the clinical significance is required to further confirmed by large- scale and multi- center study.
出处
《浙江医学》
CAS
2016年第19期1582-1586,共5页
Zhejiang Medical Journal
关键词
新生儿重症监护室
喂养方式
低出生体重儿
定植
Neonatal intensive care unit
Feeding pattern
Low birth weight infant
Colonization
