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新生儿肺炎的临床及细菌学特征

Clinical & bacteriological profile of neonatal pneumonia.

作者信息

Misra S, Bhakoo O N, Ayyagiri A, Katariya S

机构信息

Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh.

出版信息

Indian J Med Res. 1991 Nov;93:366-70.

PMID:1797646
Abstract

In a prospective study of 44 neonates (33 outborn and 11 inborn) with pneumonia, the bacteriology of pneumonia was determined by blood culture and serum counterimmunoelectrophoresis (CIEP). Twenty-nine babies also underwent lung aspiration. The lung aspirate was subjected to bacterial culture and CIEP. CIEP was done to detect the bacterial antigens of Streptococcus pneumoniae and Haemophilus influenzae. Absence of tachypnoea, found more commonly in low birth weight babies, was a poor prognostic sign. Low birth weight babies had a significantly higher mortality than babies with normal birth weight. Altogether, a bacterial etiology of neonatal pneumonia could be established in 25 cases (56.7%). In 10 babies, Strep. pneumoniae antigen was detected in serum and/or lung aspirate. Micro-organisms were cultured from blood and/or lung aspirate from 17 babies. Eleven babies (25%) grew Gram negative bacteria. The common bacteria identified in decreasing order of frequency were Strep. pneumoniae, Klebsiella pneumoniae, Staphylococcus epidermidis, Acinatobacter lowfii, Staph. aureus, Pseudoamonas aeruginosa etc. All the Gram negative bacteria as well as staphylococci were sensitive to amikacin while only 23.5 per cent was sensitive to gentamicin. All staphylococci isolated were sensitive to methicillin.

摘要

在一项针对44例肺炎新生儿(33例为出生后转入、11例为出生时即患)的前瞻性研究中,通过血培养和血清对流免疫电泳(CIEP)确定肺炎的细菌学情况。29例婴儿还接受了肺穿刺抽吸术。对肺穿刺抽吸物进行细菌培养和CIEP检测。CIEP用于检测肺炎链球菌和流感嗜血杆菌的细菌抗原。呼吸急促症状的缺失在低体重儿中更为常见,这是一个预后不良的迹象。低体重儿的死亡率显著高于正常体重儿。总体而言,25例(56.7%)新生儿肺炎可确定为细菌病因。10例婴儿的血清和/或肺穿刺抽吸物中检测到肺炎链球菌抗原。17例婴儿的血液和/或肺穿刺抽吸物培养出微生物。11例婴儿(25%)培养出革兰氏阴性菌。按频率递减顺序确定的常见细菌为肺炎链球菌、肺炎克雷伯菌、表皮葡萄球菌、洛菲不动杆菌、金黄色葡萄球菌、铜绿假单胞菌等。所有革兰氏阴性菌以及葡萄球菌对阿米卡星敏感,而对庆大霉素敏感的仅占23.5%。分离出的所有葡萄球菌对甲氧西林敏感。

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