Zhang Zhenhai, Wang Jian, Chen Wenwen, Xu Liping
Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
Children (Basel). 2024 Sep 30;11(10):1202. doi: 10.3390/children11101202.
The impact of and countermeasures for spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study.
This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks.
The prevalence of respiratory tract spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal spp. colonization increased the risk of neonatal spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, < 0.001). Infants receiving anti- spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA.
GA and maternal vaginal spp. colonization could be used to predict neonatal respiratory tract spp. colonization. An elevated WBC count combined with normal CRP is a good marker of spp. colonization/infection. It is conventional practice to start anti- spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable.
[具体菌种]在新生儿中的影响及应对措施仍存在争议。本研究旨在评估可预测呼吸道[具体菌种]定植可能性的相关围产期因素，并分析受影响婴儿随后的临床病程，从而为其诊断、治疗及未来研究提供理论依据。
这是一项对孕周小于32周出生婴儿的回顾性观察研究。
呼吸道[具体菌种]定植的发生率为25.8%（75/291），且随孕周和出生体重的降低而增加。母亲阴道[具体菌种]定植增加了新生儿[具体菌种]定植的风险，比值比为7.8（95%置信区间：3.1，20.0）。[具体菌种]定植的婴儿白细胞计数较高、C反应蛋白水平正常、机械通气撤机失败率较高（30.7%对17.1%，P = 0.014）；他们还更容易患间质性肺炎（20.0%对5.6%，P < 0.001）和支气管肺发育不良（36.0%对13.4%，P < 0.001）。接受抗[具体菌种]治疗的婴儿孕周较低、出生体重较低且呼吸综合征更严重。然而，在调整孕周后，呼吸表现的差异变得不显著。
孕周和母亲阴道[具体菌种]定植可用于预测新生儿呼吸道[具体菌种]定植。白细胞计数升高且C反应蛋白正常是[具体菌种]定植/感染的良好指标。当婴儿出现呼吸状况恶化时开始抗[具体菌种]治疗是常规做法。考虑到孕周是一个主要的中间变量，这种做法值得进一步研究。
