新生儿社区获得性重症肺炎细菌检测与诊治分析

Bacteria Detection and Analysis of Diagnosis and Treatment of Neonatal Community Acquired Severe Pneumonia

目的:探讨新生儿社区获得性重症肺炎细菌的检测及治疗情况。方法:采用无菌培养基对痰液、静脉血标本进行细菌培养。病原学检测结果出来前已存在细菌感染临床证据的患儿,给予经验用药(头孢曲松)。根据培养及药敏试验结果指导抗生素的使用,针对并发症进行抗炎、器官功能支持和其他个体化治疗。结果:120例患儿中痰细菌培养阳性患儿68例(56.67%),其中革兰阴性菌47株(56.63%),革兰阳性菌36株(43.37%)。革兰阴性菌主要为大肠埃希菌18株(21.69%)、肺炎克雷伯菌16株(19.28%);革兰阳性菌主要为肺炎链球菌17株(20.48%),甲氧西林敏感性金黄色葡萄球菌8株(9.64%)。120例患儿中血细菌培养阳性8例(6.67%)。治愈83例(69.17%),转上级院治疗20例(16.67%),好转出院15例(12.50%),死亡2例(1.67%),死亡病例均合并严重并发症。结论:新生儿重症肺炎细菌检出率高,不能忽略并发症的个体化救治,以提高救治成功率。

Objective：To investigate the detection of bacteria and treatment situation of neonatal community acquired severe pneumonia.Method：The sterile culture medium was used for the bacterial culture of sputum and venous blood samples.Empirical antibiotics treatment was given to the patients with clinical evidence of bacterial infection before the pathogeny test results come out.According to the culture and drug susceptibility test results to guide the use of antibiotics.Anti-inflammatory,organ function support and other individualized treatment for complications were given to the patients.Result：Among the 120 cases,68 cases（56.67%） were with positive sputum bacterial culture results,there were 47（56.63%） gram-negative bacteria strains,36（43.37%） gram-positive bacteria strains.Gram-negative bacteria was mainly 18 strains（21.69%） of e.coli,16 strains（19.28%） of klebsiella pneumonia.Gram-positive bacteria was mainly 17 strains（20.48%） of streptococcus pneumoniae,8 strains（9.64%） of methicillin sensitive staphylococcus aureus.8 cases（6.67%） of the 120 cases were with blood culture positive.83 cases（69.17%） were cured,20 cases（16.67%） were turned to the superior hospital for treatment,15 patients（12.50%） were improved and left hospital,2 cases（1.67%） died.The death cases were all with severe complications.Conclusion：The bacteria detection rate of neonatal severe pneumonia is high,the individualized treatment of complications can’t be ignored in order to improve the saving success rate.