摘要
目的了解住院新生儿社区获得性肺炎患儿的病原构成、分布以及不同病原体感染者的临床特点,为新生儿社区获得性肺炎的经验性诊断和治疗提供依据。方法选取2016年12月至2017年11月在首都医科大学附属北京友谊医院住院治疗的50例新生儿社区获得性肺炎患儿作为研究对象,回顾性分析其年龄、性别、住院时间等一般资料以及住院后的临床资料,包括发热、咳嗽、吐沫、呛奶和肺部体征,于入院24h内外周静脉血查呼吸道病毒IgM九联检、巨细胞病毒IgM抗体并行痰培养,于入院后72h内采集呼吸道分泌物标本,在常规检测7种呼吸道病毒的基础上加测鼻病毒、人偏肺病毒、人博卡病毒。结果新生儿社区获得性肺炎病原检出率细菌高于病毒。单一病原检出率前6位从高到低依次为金黄色葡萄球菌(22%)、呼吸道合胞病毒(12%)、大肠埃希菌(8%)、肺炎克雷伯菌(8%)、鼻病毒(6%)和EB病毒(6%)。病原检出率与新生儿日龄无关。不同病原感染患儿的临床表现无特异性。病毒感染易在冬季流行。结论细菌感染是本研究中的主要病原体,其中G^+的金黄色葡萄球菌为主要的病原菌,其次为G^-的大肠埃希菌和肺炎克雷伯菌。病毒感染中以呼吸道合胞病毒为主,其次为鼻病毒和EB病毒。不同病原所致新生儿呼吸道感染临床表现无特异性,病毒感染中呼吸道合胞病毒和鼻病毒感染多发生在冬季,细菌感染无季节特异性。
Objective To explore the pathogenic distribution and characteristics of different pathogens in neonatal community-acquiredpneumonia,and provide evidence for the empirical diagnosis and treatment of neonatal community-acquired pneumonia.Method Thehospitalized newborn with community acquired pneumonia were studied in our hospital from December 2016 to November 2017.Allof them met the diagnostic criteria of neonatal community acquired pneumonia.Retrospectively analyzed the general data such as age,gender,hospitalization time and clinical data after hospitalization,including fever,cough,spitting,choking,lung signs,and antibody ofnine respiratory virus IgM under in 24 hours of admission.cytomegalovirus(CMV) IgM antibody and sputum culture were also included.In the same time,samples of respiratory secretions collected within 72 hours after admission were routinely tested for 7 respiratory viruses.The other 3 kinds of respiratory viruses(HRV,hMPV,HBOV) were also detected.Result The detection rate of bacterium was higher thanthat of virus in neonatal community acquired pneumonia.The top six single-pathogen detection rates were staphylococcus aureus(22%),respiratory syncytial virus(12%),escherichia coli(8%),klebsiella pneumoniae(8%),rhinovirus(6%) and EB virus(6%).The detection rateof pathogens was not related to neonatal age.The clinical manifestations of different pathogen infections have no speci?c.Viral infectionsare easily prevalent in the winter season.Conclusion Bacterial infection was the main pathogen in this study.Among them,G^+ bacteriastaphylococcus aureus is the main pathogen,followed by G^- bacteria pneumonia klebsiella and escherichia coli.Respiratory syncytialvirus was the main pathogen in viral infection,followed by rhinovirus and EB virus.There is no specific clinical manifestation of differentpathogen.In viral infection,respiratory syncytial virus and rhinovirus mostly occurred in winter,and bacterial infection has no seasonalspecific.
作者
付玉林
王新宝
崔红
FU Yu-lin;WANG Xin-Bao;CUI Hong(Department of Neonatology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国医刊》
CAS
2019年第2期184-188,共5页
Chinese Journal of Medicine
关键词
社区获得性肺炎
病原学
临床特点
新生儿
Community acquired pneumonia
Etiology
Clinical characteristics
Newborn
