Booth G R, Al-Hosni M, Ali A, Keenan W J
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
J Perinatol. 2009 Jul;29(7):493-6. doi: 10.1038/jp.2009.33. Epub 2009 Apr 2.
Determine the contemporary incidence of pathogenic tracheal aspirate (TA) cultures when obtained within 12 h of birth, and to associate TA culture results with specific clinical conditions that increase the risk of infection.
A retrospective study over a 6-month period of admissions to a single outborn neonatal intensive care unit when a TA sample was collected within 12 h of birth (n=139).
In total, 9 of 139 (6.5%) TA cultures were positive for pathogenic bacterial growth. Maternal fever (relative risk (RR)=7.7, P<0.04) and clinical chorioamnionitis (RR=6.4, P<0.02) were significantly associated with pathogenic TA culture results. Infants with a pathogenic TA culture had lower white blood cell counts (7,500 vs 13,900 mm(-3), P<0.05) when compared with infants with a negative culture. In eight of the nine patients with pathogenic cultures, either the mother or the infant received antibiotics before TA sample collection.
Early TA culture is a helpful tool in diagnosing pneumonia, especially in certain clinical scenarios, including maternal fever, clinical chorioamnionitis and leukopenia. Administration of antibiotics before sample collection does not seem to preclude culture growth.
确定出生后12小时内获取的致病性气管吸出物（TA）培养物的当代发生率，并将TA培养结果与增加感染风险的特定临床情况相关联。
对一家外送新生儿重症监护病房6个月期间出生后12小时内采集TA样本的入院病例进行回顾性研究（n = 139）。
139份TA培养物中共有9份（6.5%）致病性细菌生长呈阳性。母亲发热（相对风险（RR）= 7.7，P < 0.04）和临床绒毛膜羊膜炎（RR = 6.4，P < 0.02）与致病性TA培养结果显著相关。与培养结果为阴性的婴儿相比，致病性TA培养的婴儿白细胞计数较低（7,500对13,900/mm³，P < 0.05）。在9例致病性培养的患者中，有8例在采集TA样本前母亲或婴儿接受了抗生素治疗。
早期TA培养是诊断肺炎的有用工具，特别是在某些临床情况下，包括母亲发热、临床绒毛膜羊膜炎和白细胞减少症。样本采集前使用抗生素似乎并不妨碍培养物生长。
