母婴同室新生儿皮肤菌群分析

The skin flora of neonates in maternal-neonatal unit

目的了解母婴同室新生儿皮肤菌群及皮肤感染致病菌情况,为医院感染管理提供依据。方法选取我院母婴同室区2017年3月至7月出生的新生儿,对新生儿出生5min内、出生24h后第1次沐浴前、出生48h后第2次沐浴前、出生72h后第3次沐浴前及皮肤感染部位使用琼脂直接接触培养(RODCA)法采样并将采样平皿送入检验科微生物室进行培养观察。结果本研究共纳入157例新生儿,其中23例新生儿发生皮肤感染。随着出生时间的增加,检出的细菌菌落数显著增加,差异有统计学意义(P<0.05)。新生儿出生5min内无细菌生长,出生5min之后主要检出表皮葡萄球菌(320株)、微球菌(118株)和枯草芽胞杆菌(96株)。阴道分娩新生儿皮肤感染发生率低于剖宫产新生儿(P<0.05),其感染部位致病微生物为表皮葡萄球菌(18株)。结论我院母婴同室区无外来致病菌,不会造成医院感染的暴发。新生儿出生后72h内是皮肤感染的高危时间段,医院感染管理者应高度重视。

Objective To explore the skin flora of newborns in maternal-neonatal unit and provide the basis for hospital infection management. Methods Newborns born from March to July 2017 in the maternal-neonatal unit were enrolled. The specimens were collected from the skin infection sites within 5 minutes after birth, 24 hours after birth and before the first bath, 48 hours after birth before the second bath, and 72 hours after birth before the third bath were detected with RODCA method. Results A total of 157 newborns were enrolled. There were 23 newborns with skin infection. With the increase of time length after birth, the number of bacterial colonies increased significantly (P<0.05). No bacteria were detected within 5 minutes after birth. Staphylococcus (320 strains), Micrococcus (118 strains) and Bacillus subtilis (96 strains) were the main bacteria detected 5 minutes after birth. The rate of skin infection in the vaginal delivery group was lower than in cesarean delivery group (P<0.05). The pathogenic bacteria detected from the infected sites were Staphylococci (18 strains). Conclusion There is no external pathogenic bacteria in the Maternal-neonatal unit of our hospital, which will not cause the outbreak of hospital infection. The risk of skin infection is high within 72 hours after birth.