新生儿窒息并发感染性肺炎病原学及危险因素

Etiological characteristics and risk factors for infectious pneumonia in asphyxia neonates

目的 分析新生儿窒息并发感染性肺炎病原学及危险因素。方法 选取2019年1月-2020年2月海南医学院第二附属医院收治的窒息新生儿249例为研究对象,根据新生儿是否发生感染性肺炎分为感染组51例和未感染组198例,统计窒息新生儿并发感染性肺炎现状、病原菌分布特点,采用单因素及多因素Logistic回归分析新生儿窒息并发感染性肺炎的危险因素。结果 249例窒息新生儿感染性肺炎发生率为20.48%,共分离培养出病原菌63株,其中革兰阴性菌占比58.73%,主要为大肠埃希菌和肺炎克雷伯菌;革兰阳性菌占比38.10%,主要为金黄色葡萄球菌;真菌占比3.17%。多因素Logistic回归分析结果显示,出生胎龄、出生体质量、阿氏评分、羊水污染、气管插管均为新生儿窒息并发感染性肺炎的危险因素(P<0.05)。结论 窒息新生儿并发感染性肺炎主要感染病原菌种类为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌,危险因素包括出生胎龄<32周、出生体质量<1.5 kg、阿氏评分0~3分、羊水污染、气管插管。

OBJECTIVE To analyze the etiological characteristics and risk factors for infectious pneumonia in asphyxia neonates.METHODS A total of 249 asphyxia neonates who were treated in the Second Affiliated Hospital of Hainan Medical College from Jan 2019 to Feb 2020 were recruited as the research subjects and were divided into the infection group with 51 cases and the no infection group with 198 cases according to the status of infectious pneumonia.The current status of prevalence of infectious pneumonia and distribution of pathogens were statistically analyzed.Multivariate logistic regression analysis and univariate analysis were performed for the risk factors for infectious pneumoniae in the asphyxia neonates.RESULTS The incidence of infectious pneumonia was 20.48%among the 249 asphyxia neonates.Totally 63 strains of pathogens were isolated,58.73%of which were gram-negative bacteria,38.10%were gram-positive bacteria,and 3.17%were fungi;Escherichia coli and Klebsiella pneumoniae were dominant among the gram-negative bacteria;Staphylococcus aureus was the predominant species of the gram-positive bacteria.The result of multivariate logistic regression analysis showed that gestational age,birth body weight,Apgar score,amniotic fluid contamination and endotracheal intubation were the risk factors for the infectious pneumonia in the asphyxia neonates(P<O.05).CONCLUSION E.coli,K.pneumoniae and S.aureus are the predominant species of pathogens causing the infectious pneumonia in the asphyxia neonates.The risk factors include the gestational age less than 32 weeks,birth body weight less than 1.5kg,Apgar score between O and 3 points,amniotic fluid contamination and endotracheal intubation.