Mas-Muñoz R L, Udaeta-Mora E, Rivera-Rueda M A, Morales-Suárez M
División de Pediatría, Instituto Nacional de Perinatología, México, D.F.
Bol Med Hosp Infant Mex. 1992 Dec;49(12):839-44.
During a two-year period (1988-1989), were studied newborns treated with intermittent mandatory ventilation (IMV). The goal was to know incidence of infections in these patients and characteristics of these process. Of 187, 40 (21.3%) were infected. For these neonates the mean gestational age was 33 +/- 3 weeks and average for birth weight was 1755 +/- 644 g. In 32 the infecting agent was isolated, being the most common coagulase negative Staphylococcus, it was found in 18 (45%), Klebsiella sp in 7 (17%), Escherichia coli in 1 and Candida albicans in 1. In the remaining 8 (20%) with negative cultures, postmortem confirmation was made in 5 and in 3 by clinical, radiologic or hematologic evidence. Of the 17 positive blood cultures and 3 spinal fluid culture, the same bacteria grew as in the bronchial aspirate. Were found, thrombocytopenia in 22 (55%) and leucocytosis in 19 (47%) as the most common blood changes. Pneumonia was the most common form of infection; it was found in 30 (75%); 22 of 40 died (55%). We concluded that 21.3% of neonates under IMV without infections, may get infected later in the hospital. S. epidermidis is the etiologic agent that predominates through the whole year, except during epidemics caused by others agents.
在1988 - 1989年的两年期间，对接受间歇强制通气（IMV）治疗的新生儿进行了研究。目的是了解这些患者的感染发生率以及感染过程的特征。在187名新生儿中，40名（21.3%）受到感染。这些新生儿的平均胎龄为33±3周，平均出生体重为1755±644克。在32例中分离出了感染病原体，最常见的是凝固酶阴性葡萄球菌，有18例（45%），克雷伯菌属7例（17%），大肠杆菌1例，白色念珠菌1例。在其余8例（20%）培养结果为阴性的病例中，5例通过尸检确诊，3例通过临床、放射学或血液学证据确诊。在17份阳性血培养和3份脑脊液培养中，培养出的细菌与支气管吸出物中的相同。发现最常见的血液变化是22例（55%）出现血小板减少和19例（47%）出现白细胞增多。肺炎是最常见的感染形式，有30例（75%）；40例中有22例死亡（55%）。我们得出结论，在接受IMV治疗且未感染的新生儿中，21.3%可能在医院后期发生感染。除了由其他病原体引起的流行期间外，表皮葡萄球菌是全年占主导的病原体。
