摘要
目的分析新生儿病理性黄疸病原菌分布特征、耐药性,检测降钙素原(PCT)及C反应蛋白(CRP)水平变化,并探讨其临床意义。方法收集2016年1月-2018年1月本院收治的新生儿病理性黄疸100例。其中,细菌性感染致黄胆患儿56例为感染组,非细菌性黄胆患儿44例为非感染组。同期健康新生儿50例为对照组。采集受检新生儿血液标本,利用半自动细菌鉴定分析系统进行菌株的分离鉴定和药敏试验;利用全自动化学发光仪和免疫比浊法检测3组新生儿血PCT及CRP水平,并进行比较分析。结果100例病理性黄疸新生儿血液标本共检出病原菌59株,其中革兰阳性菌23株(占38.98%),以金黄色葡萄球菌为主;革兰阴性菌35株(占59.33%),以大肠埃希菌和肺炎克雷伯菌为主;真菌1株(占1.69%)。金黄色葡萄球菌对青霉素及红霉素耐药率为93.33%~100%,对阿米卡星、左氧氟沙星及头孢唑林耐药率在60.00%~73.33%之间。革兰阴性杆菌对青霉素、红霉素、复方新诺明、复方磺胺甲噁唑和头孢呋辛的耐药率在66.67%~100.0%之间,对头孢吡肟、阿米卡星、亚胺培南耐药率为1.67%~25.00%。感染组和非感染组患儿血清PCT及CRP分别为(9.32±1.02)mg/L、(9.06±1.22)μg/L和(3.58±0.45)mg/L、(0.89±0.19)μg/L,与对照组的(1.14±0.17)mg/L和(0.27±0.16)μg/L比较差异均有统计学意义(P<0.05)。结论新生儿病理性黄疸病原菌以金黄色葡萄球菌、大肠埃希菌和肺炎克雷伯菌多见,治疗时应根据感染病原菌的药敏试验结果选择合适的抗菌药物;新生儿病理性黄胆感染组血PCT及CRP升高,因此检测血PCT及CRP可作为区分细菌性与非细菌性病理性黄疸的重要标志物。
Objectives To analyze the distribution and drug resistance of pathogens causing pathological jaundice in newborns and to measure levels of procalcitonin(PCT)and C reactive protein(CRP)in order to explore their clinical significance.Methods Data on 100 newborns with pathological jaundice seen at this Hospital from January 2016 to January 2018 were collected.Of those newborns,56 with jaundice due to a bacterial infection served as patients with an infection,and 44 with jaundice due to some other cause served as patients without an infection.Fifty healthy newborns seen in the same period served as the control group.Blood samples were collected from newborns,and a semi-automated microbial identification and analysis system was used to isolate and identify strains of pathogens.Levels of PCT and CRP in the three groups were measured using an automated chemiluminescence assay and immunoturbidimetry.Results A total of 59 pathogens were detected in 100 blood samples from patients with pathological jaundice,including 23 strains of Gram-positive bacteria(38.98%).The main Gram-positive bacterium was Staphylococcus aureus.Thirty-five strains of Gram-negative bacteria(59.33%)were detected.The main Gram-negative bacteria were Escherichia coli and Klebsiella pneumoniae.One strain of a fungus(1.69%)was detected.The resistance of Staphylococcus aureus to penicillin and erythromycin ranged from 93.33-100%,and its resistance to amikacin,levofloxacin,and cefazolin was between 60.00%and 73.33%.The resistance of Gram-negative bacilli to penicillin,erythromycin,cotrimoxazole,sulfamethoxazole and trimethoprim,and cefuroxime was between 66.67%and 100.0%.The resistance of Gram-negative bacilli to cefepime,amikacin,and imine was between 1.67%and 25.00%.Serum PCT and CRP were 9.32±1.02 mg/L and 9.06±1.22μg/L in patients with an infection and 3.58±0.45 mg/L and 0.89±0.19μg/L in patients without an infection.Serum PCT and CRP differed significantly from levels in the control group(1.14±0.17 mg/L and 0.27±0.16μg/L)(P<0.05).Conclusion T
作者
贾南
贾毅
何薇
吴新婷
张东平
卞伟妮
JIA Nan;JIA Yi;HE Wei;WU Xin-ting;ZHANG Dong-ping;BIAN Wei-ni(Neonatal Department,The Second Hospital Affiliated with the Xi'an College of Medicine,Xi'an,Shanxi,China 710038)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第9期1088-1090,1095,共4页
Journal of Pathogen Biology
