摘要
目的研究新生儿重症监护病房(NICU)医院获得性肺炎(HAP)临床和微生物学特点,为医院感染病例及时监测、早期诊断和治疗提供依据。方法 2008年1月-2009年12月NICU监测并确诊医院获得性肺炎68例,分析研究临床及病原菌特点。结果 68例患儿中,男性比例稍高,占54.41%,低出生体重早产儿占82.44%;患儿临床症状和体征不典型,X线表现肺部纹理增多或增强的阳性率为79.41%,右肺斑片影、双肺斑片影、左肺斑片影阳性率分别为36.76%、33.82%、10.29%;68例HAP患儿的痰培养中检出病原菌37株,均为革兰阴性杆菌,最有效的抗菌药物是亚胺培南和美罗培南,其次为加酶抑制剂的复合制剂。结论 NICU医院获得性肺炎的临床症状和体征常不典型,使其早期诊断有一定的困难;采用X线影像检查协助诊断非常必要;亚胺培南、美罗培南和加酶抑制剂的复合制剂可以作为经验治疗用药。
OBJECTIVE To discuss the clinical and microbiological features of hospital-acquired pneumonia in NICU,to provide the basis for the timely surveillance,early diagnosis and early treatment of nosocomial infection.METHODS A total of 68 cases of hospital-acquired pneumonia in NICU from Jan 2008 to Dec 2009 were monitored,the pathogenic characteristics were analyzed.RESULTS Among 68 cases of patients,the proportion of male was slightly higher,accounting for 54.41%,while the premature children with low birth weight accounted for 82.44%;Clinical symptoms and signs were atypical;X-ray performance showed that spotted-patches shadow were increased or enhanced with the positive rate of 79.4%,the positive rates of right lung shadow plaques,both lungs shadow plagues and left lung shadow plaques were 36.76%,33.82% and 10.29%,respectively.37 strains were found in the sputum culture of 68 cases of children with HAP,all of which were Gram-negative bacilli,the most effective antibiotics were imipenem and meropenem,followed by the compound preparation of enzyme inhibitors.CONCLUSIONS The clinical signs and symptoms of HAP in NICU are often atypical that make the early diagnosis of this disease to be difficult;Using x-ray for assisting the diagnosis is very necessary to assist the diagnosis;Imipenem,meropenem and compound preparation of enzyme inhibitors can be used as empirical application of drugs for the treatment.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第6期1128-1130,共3页
Chinese Journal of Nosocomiology
关键词
新生儿重症监护病房
医院获得性肺炎
临床研究
Neonatal intensive care unit
Hospital-acquired pneumonia
Clinical research