Department of Newborn Services, the George Washington University and Children's National Medical Center, Washington, DC, USA.
Am J Perinatol. 2011 Apr;28(4):315-20. doi: 10.1055/s-0030-1268711. Epub 2010 Nov 29.
We examined the relationship between the use of nasal continuous positive airway pressure (CPAP) and nasal colonization among low-birth-weight (LBW) infants. We prospectively cultured the nares of LBW infants on admission and weekly until hospital discharge. The modality of respiratory support during each culture was recorded. Bivariate and multivariate analyses were conducted to test the relationship between CPAP and nasal colonization. Analyses were repeated after stratifying infants into three birth-weight categories: 1500 to 2499 g, 1000 to 1499 g, and < 1000 g. In total, 766 nasal cultures were obtained from 167 infants. Nasal colonization with gram-negative bacilli was increased with the use of CPAP in all birth-weight categories ( P < 0.05) and with vaginal delivery in infants weighing < 1000 g and 1500 to 2499 g ( P = 0.04 and P = 0.02, respectively). Nasal colonization with any potential pathogen increased with the use of CPAP in all birth-weight categories ( P < 0.001), with the presence of chorioamnionitis in infants < 1000 g ( P = 0.055) and at younger gestational age in infants 1000 to 1499 g ( P = 0.0026). Caucasian infants 1500 to 2499 g had less colonization than infants of other races ( P = 0.01). Nasal CPAP is associated with increased colonization with gram-negative bacilli.
我们研究了使用持续气道正压通气（CPAP）与低出生体重儿（LBW）鼻部定植的关系。我们前瞻性地在入院时和每周对 LBW 婴儿的鼻腔进行培养，直到出院。记录了每次培养时呼吸支持的方式。采用双变量和多变量分析来检验 CPAP 与鼻腔定植的关系。将婴儿分为三个出生体重类别：1500 至 2499 克、1000 至 1499 克和<1000 克，对其进行重复分析。共对 167 例婴儿的 766 份鼻培养物进行了分析。在所有出生体重类别中，使用 CPAP 与革兰氏阴性杆菌的鼻部定植增加（P<0.05），在体重<1000 克和 1500 至 2499 克的婴儿中与阴道分娩相关（P=0.04 和 P=0.02）。在所有出生体重类别中，使用 CPAP 与任何潜在病原体的鼻腔定植增加（P<0.001），在体重<1000 克的婴儿中存在绒毛膜羊膜炎（P=0.055）和在 1000 至 1499 克的婴儿中胎龄较小（P=0.0026）。1500 至 2499 克的白人婴儿比其他种族的婴儿定植少（P=0.01）。鼻 CPAP 与革兰氏阴性杆菌定植增加相关。
