胃液检查在新生儿早期细菌感染诊断中的应用

Application of Gastric Fluid Test on Diagnosis of Early Onset of Neonatal Bacterial Infections

目的探讨胃液检查在新生儿早期细菌感染诊断中的临床价值。方法随机选择2005年9～12月昆明医学院第一附属医院母婴医学中心NICU中日龄≤72h且有围生期感染高危因素的新生儿120例。均在出生1h内开奶前行胃液涂片镜检、胃液细菌培养检查。按患儿临床表现及实验室检查分为确定感染组、临床感染组及非感染组。以统计学方法分析胃液检查在新生儿早期细菌感染诊断中的价值。结果胃液涂片镜检、胃液细菌培养2个感染组与非感染组相比，有显著统计学差异（Pa〈0．01），2个感染组间比较无显著差异（P〉0．05）。胃液培养结果显示大肠埃希菌为新生儿早期感染的最常见致病菌，占46．875％。其中产超广谱β-内酰胺酶（ESBLs）的耐药菌株所占比例高达40．0％。结论胃液涂片镜检及胃液细菌培养检查阳性率高，在新生儿早期细菌感染的诊断中有较高的应用价值。

Objective To discuss the clinical application of gastric fluid test on diagnosis of early onset of neonatal bacterial infections. Methods In the first affiliated hospital of Kunming medical college, 120 high - risk infants with predisposing factors with in 72 hours after birth were selected from the Medical Center of Mother and Infant. Smear test and bacterial culture of gastric fluid before feeding and with in 1 hour after birth were performed on every investigated object. These newborn infants were divided into three groups：confirmed infectious group, infectious group and non - infectious group according to their manifestation and laboratory examination. The clinical application of gastric fluid test was analyzed statistically. Results Smear test and bacterial culture of gastric fluid were significantly different between the infectious groups and the non - infectious group （Pa 〈 0.01 ）. There was no significant difference between two infectious groups （P 〉 0.05 ）. The bacterial culture of gastric fluid indicated that E. coli was the most common pathogen in early onset of neonatal bacterial infections, accounting for 46. 875%. The 40.0% of E. coli produced extended spectrum 13 lactamases （ESBLs）. Conclusions The positive rate is high of smear test and bacterial culture of gastric fluid. They are useful to diagnosis of early onset of neonatal bacterial infections.