新生儿肺透明膜炎病机械通气治疗中下呼吸道分泌物细菌培养及药物敏感试验分析

Analysis of bacteria taken from the lower respiratory tract secretions in neonates with hyaline membranedisease under mechanical ventilation and microlial sensitivity tests of isolated bacteria

目的了解新生儿肺透明膜病(HMD)机械通气治疗中下呼吸道感染的常见病原菌和相应敏感药物.方法 对本院过去3年46例确诊为HMD行机械通气的患儿下呼吸道分泌物进行细菌培养,用细菌生化编码微量管法鉴定细菌,纸片扩散法做药敏试验.结果46例机械通气患儿,培养阳性率60.9%(28/46)机械通气3天以上培养阳性率100%(1/18).常见病原菌:肺炎克雷伯菌,假单胞菌,它们对常用抗生素耐药.对环丙沙星的敏感率分别为 92.3%(12/13)和66.7%(8/12).丁胺卡那霉素敏感率分别为39%(5/13)和50%(6/12).结论 机械通气HMD患儿易发生下呼吸道感染,机械通气3天以上时更为明显.常见的致病菌为肺炎克雷伯菌和假单胞菌等条件致病菌,对一般抗生素不敏感,可选用环丙沙星或丁胺卡那霉素.

ve To investigate the causative bacteria and the corresponding sensitive drugs in ventilated hyaline membrane disease (HMD) neonates complicated lower respiratory tract infection. Methods In the past three years, the secretiones from the lower respiratory tract of 46 cases of HMD neonates under artificial ventilation were cultured. Bacteria were identified with biochemical methods. Microbial sensitivity tests were determined by paper disc diffusion methods Results In 46 cases of mechanically ventilated neonates, the positive rate of culture taken from the secretions lower respiratory tract was 60. 9% (28/46), for those neonates ventilated more than 3 days the positive rate was 100% (18/18), The common bacteria were klebsiella pneumoniae and Pseudomonas aeruginosa which were resistant to commonly used antibiotics. Their sensitivity rates to ciprofloxacin were 92% (12/13) and 66% (8/12) respectively, to amikacin were 39% (3/15)and 50% (6/12)respectively, Conclusions Ventilated neonats with HMD are easy to Suffer from lower respiratory infection, espeially for those ventilated more than 3 days. The common bacteria were Klebsiella pneumoniae and Pseudomonas aeruginosa, which are not sensitive to commonly used antibiotics except ciprofloxacin and amikacin.