新生儿沙眼衣原体肺炎的临床及实验研究

Experimental and clinical study of neonatal chlamydia trachomatis pneumonia

目的探讨新生儿沙眼衣原体(CT)肺炎的发病情况及临床特点。方法对128例新生儿肺炎应用细胞培养检测CT,同时应用PCR扩增其主要外膜蛋白(MOMP)检测CT,应用另一引物对原PCR阳性标本再确证,并分析CT肺炎的新生儿临床资料。结果128例标本中培养阳性29例,阳性率22.7%;两引物PCR均阳性36例,阳性率28.1%;新生儿CT肺炎大多数起病缓慢,临床症状、体征和X线表现无特异性。结论CT是新生儿肺炎常见的病原体,病情迁延,青霉素和头孢类抗生素治疗无效的肺炎应考虑到CT肺炎。细胞培养是诊断CT肺炎的“金标准”,两引物PCR方法的确证可减少因PCR敏感性所致的假阳性。

Objectives To explore the pathogenesis and clinical feature of neonatal chlamydia trachomatis pneumonia by studying the clinical and laboratory data from 128 newborn infants with chlamydia trachomatis pneumonia. Methods Polymerase chain reaction （PCR） and cell culture were done to isolate chlamydia trachomatis. PCR was used to amplify a large part of the major outer membrane protein gene （MOMP）, and the positive was confirmed by PCR with another primer. The clinical data of chlamydia trachomatis pneumonia in newborn infants were also studied. Results Twenty-nine cases were positive in cell culture （positive rate was 22.7%）, 36 cases was positive with double promoter PCR （positive rate was 28.1%） . Most of the patients were in chronic onset and with no specific clinical manifestation and X-ray presentation. Conclusions Chlamydia trachomatis is the most common causes of the neonatal pneumonia. When neonatal pneumonia has prolonged course with no response to penicillin and cefroridine, the diagnosis of chlamydia trachomatis should be considered. Cell culture is the golden diagnostic standard for chlamydia trachomatis. Double primer PCR can reduce the false positive of the PCR caused by high sensitivity.