| 蒋 萍,刘杰波,张 婧,张 曼,饶丹丹,赵 琳.新生儿坏死性小肠结肠炎病原菌分布、耐药性及发病的影响因素分析[J].,2021,(15):2863-2867 |
| 新生儿坏死性小肠结肠炎病原菌分布、耐药性及发病的影响因素分析 |
| Analysis of Pathogenic Bacteria Distribution, Drug Resistance and Influencing Factors of the Incidence of Neonatal Necrotizing Enterocolitis |
| 投稿时间：2021-03-13 修订日期：2021-03-31 |
| DOI：10.13241/j.cnki.pmb.2021.15.013 |
| 中文关键词: 新生儿 坏死性小肠结肠炎 病原菌 耐药性 影响因素 |
| 英文关键词: Neonatal Necrotizing enterocolitis Pathogenic bacteria Drug resistance Influencing factors |
| 基金项目:国家自然科学基金项目（81670652） |
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| 中文摘要: |
| 摘要 目的：观察新生儿坏死性小肠结肠炎（NEC）病原菌分布、耐药性，并分析NEC患儿发病的影响因素。方法：选取2016年8月~2020年9月期间在我院接受治疗的NEC患儿50例（NEC组），另选取同期于我院出生的100例健康新生儿作为对照组。观察NEC患儿病原菌分布、耐药性，并分析NEC发病的影响因素。结果：50例NEC患儿共培养出病原菌63株。病原菌中革兰阴性菌38株，占比60.32%；革兰阳性菌23株，占比36.51%；真菌2株，占比3.17%。大肠埃希菌、肺炎克雷伯菌均对氧氟沙星、头孢哌酮、头孢他啶、头孢唑林、阿莫西林、氨苄青霉素、环丙沙星、头孢曲松的敏感性较低，对亚胺培南/西司他丁、哌拉西林/他唑巴坦、美罗培南、多粘菌素高度敏感。单因素分析结果显示，NEC发病与新生儿体重、母乳喂养、产前使用糖皮质激素、妊娠期糖尿病、妊娠期高血压、新生儿Apgar评分、是否合并肺部感染、合并败血症有关（P<0.05）。多因素Logistic回归分析发现：母乳喂养是NEC发病的保护因素，合并败血症、妊娠期糖尿病、新生儿体重、合并肺部感染、新生儿Apgar评分均是NEC发病的危险因素（P＜0.05）。结论：NEC患儿的病原菌以革兰阴性菌为主，同时影响NEC发病的因素较多，应结合相关的影响因素制定针对性干预或治疗措施，以减少NEC的发病风险。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the pathogenic bacteria distribution and drug resistance in neonatal necrotizing enterocolitis (NEC), and to analyze the influencing factors of the incidence of NEC children. Methods: 50 NEC children who were treated in our hospital from August 2016 to September 2020 were selected (NEC group), and 100 cases of healthy newborns received in our hospital during the same period as the control group, the pathogenic bacteria distribution and drug resistance in NEC children were observed, and the influencing factors of the incidence of NEC children were analyzed. Results: A total of 63 strains of pathogenic bacteria were isolated from 50 cases of NEC children. There were 38 strains of Gram-negative bacteria, accounting for 60.32%, 23 strains of Gram-positive bacteria, accounting for 36.51%, and 2 strains of fungi, accounting for 3.17%. Escherichia coli and Klebsiella pneumoniae were all less sensitive to ofloxacin, cefoperazone, ceftazidime, cefazolin, amoxicillin, ampicillin, ciprofloxacin and ceftriaxone, and they had highly sensitive to imipenem/cestastatin, piperacillin/tazobactam, meropenem and polymyxin. Univariate analysis showed that the incidence of NEC was associated with neonatal weight, breast-feeding, prenatal use of glucocorticoids, gestational diabetes mellitus, gestational hypertension, neonatal Apgar score, whether combined with pulmonary infection and combined with sepsis(P<0.05). Multivariate logistic regression analysis showed that breast-feeding was the protective factor of the incidence of NEC, and combined with sepsis, gestational diabetes mellitus, neonatal weight, combined with pulmonary infection and neonatal Apgar score were the risk factors of the incidence of NEC(P<0.05). Conclusion: Gram negative bacteria are the main pathogens of NEC. At the same time, there are many factors that affect the incidence of the incidence of NEC, so targeted intervention or treatment measures should be developed in combination with relevant influencing factors to reduce the risk of the incidence of NEC. |
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