新生儿咽拭子培养的临床意义

Clinical value of throat swab culture taking from neonatus

【目的】探讨入院24 h之内新生儿咽拭子培养常见病原菌的分布及药物敏感率情况,为临床合理使用抗菌药提供依据。【方法】选择2009年6月-2011年6月我院新生儿病房疑似感染的患儿724例(感染组和非感染组)为观察组及50例无疑似感染因素的患儿为对照组,入院24 h内进行咽部标本采集,作咽拭子培养及药敏实验,对其病原菌分布及耐药情况进行分析。【结果】新生儿入院时感染性疾病的致病菌带菌率72.47%,非感染性疾病患儿致病菌带菌率66.30%,对照组致病菌带菌率为00.00%,带入菌种30种,以表皮葡萄球菌为主(19.12%),其次大肠埃希菌(17.13%)和鲍曼不动杆菌(16.73%),其他致病菌(47.02%)。对照组与观察组菌株分布有统计学意义,感染组与非感染组菌株分布无统计学意义。葡萄球菌对青霉素、红霉素等耐药率相当高。万古霉素、替考拉宁、头孢唑啉对葡萄球菌具有良好的抗菌活性。大肠埃希菌、鲍曼不动杆菌对头孢哌酮/舒巴坦、亚胺培南的敏感率较高。【结论】对新入院新生儿入院24h之内采取咽拭子培养,进行细菌学检测及药敏,为临床医生合理用药,提供了依据;对及早采取消毒隔离措施,预防和控制新生儿科的医院感染有重要意义。

【Objective】To discuss the clinical value of throat swab culture taking from neonatal within 24 hours of hospitalization.【Methods】 A total of 724 newborns suspected with high-risk factor of infection born at June 2009 to June 2011 admitted in the second hospital of Tianjin.Hedical university and 50 cases of without high-risk factor were enrolled in this study.The 724 cases were divided into infection and non-infection group according to their manifestation and laboratory examination and the 50 cases were used as control.Throat swab was taken and cultured within 24 h of admission and drug-sensitivity of the isolates was determined.【Results】 The germ bearing rate in infected neonatus was 72.47%.And that for noninfected neonatus was 66.30% 30 kinds of bacteria were found among them.Staphylococcus epidemidis accounting for 19.12%followed by 17.13% of Escherichia colibased and Baumanii 16.73%,47.02% were the others.There was no significant difference between the infection group and the non-infection group in the culture result of throat swab.There was significant difference between the control group and the experimental group in culture result of throat swab.Most of Staphylococcus,isolates were sensitive to vancomycin,teicoplanin and cefazolin,while resistant to penicillin,and erythromycin.Escherichia colibased and Baumanii were sensitive to cefoperazone/sullbactam,and imipenem.【Conclusion】 Taking bacterial culture and monitoring the throat swab of neonatus newly admitted has provided a guidance for rational use of drugs and taking disinfection and isolation measures.