摘要
目的 检测新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome, NRDS)患者机械通气后并发呼吸道感染的菌群特征,并探究其与血清降钙素原(procalcitonin, PCT)和CD64指数的相关性。方法 2019年1月-2021年1月宜春市妇幼保健院收治的NRDS患儿118例,均给予机械通气,根据患儿是否发生呼吸道感染将其分为感染组(27例)和未感染组(91例)。采集患儿痰液作细菌培养检查,分析呼吸道菌群特征;检测新生儿痰液中细菌数、丰富度、香农-威纳指数,以及血清PCT和CD64水平,分析血清PCT和CD64与丰富度、香农-威纳指数的相关性。结果 118例NRDS患儿中27例确诊为呼吸道感染,呼吸道感染发生率为22.65%。两组患儿在性别、胎龄、出生体质量、入院体质量等基线资料差异均无统计学意义(均P>0.05);感染组患儿呼吸机使用时间和住院时间与未感染组比较差异均有统计学意义(均P<0.01)。27例呼吸道感染患儿分离出病原菌28株,以大肠埃希菌、肺炎克雷伯菌、绿脓杆菌多见;28株病原菌中的25株革兰阴性菌对环丙沙星、亚胺培南、哌拉西林、丁胺卡那、头孢他啶、氨苄西林、妥布霉素、阿米卡星和庆大霉素的敏感性为20.00%~80.00%。27例感染患儿中插管<3 d组细菌条带丰富度和香农-威纳指数均显著低于插管≥3 d组(均P<0.05),且血清PCT与细菌条带丰富度和香农-威纳指数均呈正相关(r值分别为0.561和0.601,均P<0.05),CD64指数与细菌条带丰富度和香农-威纳指数均呈正相关(r值分别为0.552和0.634,均P<0.05)。结论 NRDS患儿呼吸道感染率较高,血清PCT和CD64指数与细菌条带丰富度和香农-威纳指数呈正相关,可用于评估、诊断新生儿呼吸道感染的发生及预后。
Objective To discuss the characteristics of respiratory tract microflora and its relationship with serum PCT and CD64 levels in neonatal respiratory distress syndrome(NRDS) complicated with respiratory tract infection after mechanical ventilation. Methods 118 children with NRDS admitted to Yichun Maternity and Child Health Hospital from January 2019 to January 2021 were treated with mechanical ventilation.According to whether the children had respiratory tract infection, they were divided into infection group(n=27) and non-infected group(n=91).Neonatal sputum was collected for bacterial culture examination to analyze the characteristics of respiratory tract flora.The number of target strip bacteria, richness, Shannon-Wiener index, serum PCT and CD64 levels in neonatal sputum were detected, and the correlation between serum PCT and CD64 and bacterial band richness and Shannon-Weiner index was analyzed. Results Among the 118 cases of NRDS,27 cases were diagnosed as respiratory tract infection, and the incidence of respiratory tract infection was 22.88%.There was no significant difference in sex, gestational age, birth weight and admission weight between the two groups(P>0.05).The ventilator use time and hospitalization stay in the infection group were significantly higher than those in the non-infected group(P<0.05).28 strains of pathogenic bacteria were isolated from 27 children with respiratory tract infection, most of which were Escherichia coli,Klebsiella pneumonia and Pseudomonas aeruginosa.Among the 28 strains of pathogenic bacteria, there were 25 strains of Gram-negative bacteria.The sensitivity of Gram-negative bacteria to ciprofloxacin, imipenem, piperacillin, amikacin, ceftazidime, ampicillin, tobramycin, amikacin and gentamicin were 20.00%~ 80.00%.In the 27 cases of infected children, the bacterial band richness and Shannon-Wiener index in <3 d intubation group were significantly lower than those in ≥3 d intubation group(P<0.05).Serum PCT was positively correlated with bacterial band richness and Shann
作者
陈余粮
郭宗荣
朱小燕
CHEN Yu-liang;GUO Zong-rong;ZHU Xiao-yan(Yichun Maternal and Child Health Hospital,Yichun,Jiangxi 336000,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2022年第10期1204-1207,共4页
Journal of Pathogen Biology
关键词
呼吸窘迫综合征
呼吸道感染
呼吸道菌群特征
降钙素原
CD64指数
neonatal respiratory distress syndrome
respiratory tract infection
respiratory tract microflora characteristics
procalcitonin
CD64 levels
