新生儿黄疸合并医院肺部感染的病原学特点及影响因素

Etiological characteristics and influencing factors of neonatal jaundice complicating hospital pulmonary infection

目的探讨新生儿黄疸合并医院肺部感染的病原学特点及影响因素,为临床治疗提供依据。方法选取2016年10月至2017年9月于该科住院的新生儿黄疸患儿108例,分析发生医院肺部感染患儿的病原学特点,记录患儿性别、胎龄、新生儿Apgar评分、宫内窘迫发生情况,以及产妇孕次、低血糖、妊娠合并症、羊水污染、年龄、分娩方式、母乳缺乏、体质量下降、使用催产素情况,分析新生儿黄疸合并医院肺部感染的影响因素。结果108例新生儿黄疸患儿中有20例患儿出现医院肺部感染,感染率为18.52%。对20例感染患儿进行检测,共分离出48株病原菌。其中肺炎克雷伯菌10株,占20.83%,位居第1位;第2位为大肠埃希菌,共8株,占16.67%;第3位为凝固酶阴性葡萄球菌,共7株,占14.58%。多因素Logistic回归分析显示,产妇年龄、分娩方式、母乳缺乏、体质量下降、使用催产素,以及新生儿Apgar评分、胎儿宫内窘迫是新生儿黄疸合并医院肺部感染的独立危险因素。结论产妇年龄、分娩方式、母乳缺乏、体质量下降、使用催产素,以及胎儿宫内窘迫等因素是造成新生儿黄疸合并医院肺部感染的独立危险因素。

Objective To explore the etiological characteristics and influencing factors of neonatal jaundice complicating hospital pulmonary infection so as to provide an evidence for clinical treatment.Methods One hundred and eight neonates with jaundice hospitalized in the pediatrics department of this hospital from October 2016 to September 2017 were selected to analyze the etiological characteristics in the neonatal patients with pulmonary infection among them.The fetal sex,fetal age,neonatal Apgar score,intrauterine distress,maternal gravidity,hypoglycemia,pregnancy complications,amniotic fluid pollution,maternal age,delivery mode,lack of breast milk,decrease of parturient body mass and oxytocin use were recorded.Then the influencing factors of neonatal jaundice complicating hospital pulmonary infection were analyzed.Results Among 108 neonates with jaundice,20 cases appeared hospital pulmonary infection,with an infection rate of 18.52%.Twenty cases of infection were detected and 48 strains of pathogenic bacteria were isolated.Among them,there were 10 strains of Klebsiella pneumoniae,accounting for 20.83%,which occupied the top place;the second was Escherichia coli,8 strains,accounting for 16.67%;the third was coagulase negative staphylococcus,7 strains,accounting for 14.58%.The multifactor Logistic regression analysis results showed that the maternal age,delivery mode,lack of breast milk,decrease of parturient body mass,oxytocin use and intrauterine distress,Apgar score were the independent influencing factors causing neonatal jaundice complicating hospital pulmonary infection.Conclusion The factors such as maternal age,delivery mode,lack of breast milk,decrease of parturient body mass,oxytocin use and intrauterine distress and other factors are the independent risk factors causing neonatal jaundice complicating nosocomial pulmonary infection.