新生儿消化系统感染性疾病的病原学分析及临床诊治

Etiological analysis of infectious diseases in digestive systems of neonates and clinical diagnosis and treatment

目的对新生儿消化系统感染性疾病的病原学及诊治方法进行分析,为防治新生儿消化系统感染性疾病提供临床参考依据。方法选择医院2012年3月-2013年3月123例消化系统感染性疾病的新生儿,均留取粪便进行培养,观察病原体构成及药敏情况,对诊断与治疗效果进行评价。结果共培养出92株病原体,其中细菌33株占35.87%;病毒35株占38.04%,真菌24株占26.08%;医院感染的36例患儿病原体检出率100.0%,社区感染的87例患儿检出病原体56株,检出率64.37%,明显低于医院感染(P<0.05);医院感染的主要病原体是轮状病毒、肺炎克雷伯菌、解鸟氨酸克雷伯菌;社区感染的主要病原体是白色假丝酵母菌、轮状病毒、粪肠球菌;医院感染病原体耐药率普遍较高,对氨苄西林、头孢类抗菌药物普遍耐药;经对症治疗后,99例感染性腹泻患儿治愈91例治愈率91.92%,好转8例好转率8.08%,24例鹅口疮患儿治愈23例治愈率95.83%,好转1例好转率4.17%,总有效率100.0%。结论新生儿消化系统感染性疾病的病原体有细菌、病毒与真菌,主要以轮状病毒为主,医院感染的病原体存在检出率高与耐药性强的特点,在诊治时应根据上述特点区别对待。

OBJECTIVE To analyze the etiology of infectious diseases in digestive systems of neonates and put forward diagnosis and treatment measures so as to prevent the infectious diseases in the digestive systems of the neonates.METHODS A total of 123neonates with digestive infectious diseases,who were treated in the hospital from Mar 2012to Mar 2013,were enrolled in the study,then the stool specimens were sampled for culture,the distribution of pathogens and the drug susceptibility were observed,the therapeutic effect was evaluated.RESULTS Totally 92strains of pathogens have been isolated,including 33（35.87%）strains of bacteria,35（38.04%）of viruses,and 24（26.08%）strains of fungi.The pathogens were isolated from all the 36neonates with the detection rate of 100.0%;56strains of pathogens were isolated from 87neonates with community-acquired infections,the detection rate was 64.37%,significantly lower than that of the neonates with hospital-acquired infections（P＆lt; 0.05）.The rotavirus,Klebsiella pneumoniae,and Klebsiella ornithinolytica were the predominant pathogens causing the nosocomial infections;the Candida albicans,rotavirus,and Enterococcus faecalis were dominant in the pathogens causing the community-acquired infections.The pathogens causing the nosocomial infections were highly drug-resistant,and the drug resistance rates to ampicillin and cephalosporins were high.After the symptomatic treatment,91of 99neonates with infective diarrhea were cured with the cure rate of 91.92%,and 8（8.08%）neonates were improved;23of 24neonates with thrush were cured with the cure rate of 95.83%,1（4.17%）neonate was improved,and the total effective rate was 100.0%.CONCLUSION The pathogens causing digestive infectious diseases in the neonates include the bacteria,viruses,and fungi,among which the rotavirus is dominant.The pathogens causing the nosocomial infections are characterized by the high detection rate and the high drug resistance rate,and the diagnosis and treatment should be differentiated for the neonates according to the above characteristics.