新生儿感染性肺炎的痰细菌培养检测及免疫功能研究

Bacteria testing and immunological studies on neonatal infectious pneumonia.

目的探讨新生儿感染性肺炎痰培养结果,细菌药物耐药情况及其免疫功能的变化。方法负压吸痰,送痰液进行细菌培养及药物敏感试验,同时采集患儿血液检测特种蛋白C3、C4、IgG、IgM、IgA;;,对结果进行分析,选取同期非肺炎新生儿30例作为对照组。结果 79例感染性肺炎患儿痰培养细菌阳性35例,常见大肠埃希菌(31.4%)、金黄色葡萄球菌(22.9%)、肺炎克雷伯菌(20.0%)、阴沟肠杆菌(11.4%)。大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对亚胺培南均敏感,金黄色葡萄球菌对万古霉素敏感。各组间C3、C4值两两比较均有统计学意义(P<0.05);肺炎细菌感染组与其他感染组IgM值大于对照组(P<0.05)。结论新生儿肺炎细菌感染中病原菌以革兰氏阴性感染为主,对亚胺培南敏感性最高。革兰氏阳性菌对万古霉素尚未出现耐药性。低补体水平将不能很好发挥补体等生物学功能,从而导致易患肺炎等感染性疾病。不同病原体感染可影响患儿补体合成。IgM能在新生儿体液免疫中发挥重要作用。

Objective：To explore neonatal infectious pneumonia sputum culture results,drug resistance of bacteria and their immune function changes.Methods： Vacuum suction,send sputum for bacterial culture and drug sensitivity test,while collecting their blood tests with C3,C4,IgG,IgM,IgA,the results were analyzed.Results： 35 infectious bacteria were identified,including Escherichia coli（31.4%）,Staphylococcus aureus（22.9%）,Klebsiella pneumoniae（20.0%）,Enterobacter cloacae（11.4%）.They were sensitive to imipenem.Staphylococcus aureus were sensitive to vancomycin.Pair-comparison,C3,C4 values were statistically significant in three groups（P0.05）IgM with pneumonias were higher than those of the contol（P0.05）.Conclusion： Gram-negative bacterial infection was the main pathogen in neonatal pneumonia.It is sensitive to imipenem.Gram-positive bacterial is sensitive to vancomycin.Low complement levels would not play very well complement the biological function,leading to susceptibility to infectious diseases such as pneumonia.Different pathogens can affect complement synthesis.IgM in neonatal play an important role in humoral immunity.