NICU, Zhejiang University School of Medicine Children's Hospital National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
Laboratory Department, Zhejiang University School of Medicine Children's Hospital National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
BMJ Paediatr Open. 2024 Nov 2;8(1):e002783. doi: 10.1136/bmjpo-2024-002783.
The objective of this study is to assess the relationship between non-invasive ventilation (NIV) and the colonisation of oral and nasal microbiota in preterm infants within the neonatal intensive care unit (NICU).
A prospective cohort study.
The NICU of Zhejiang University Children's Hospital.
Patients include preterm infants with a gestational age of 28-35 weeks, enrolled within the first 24 hours of life.
Infants were categorised based on respiratory support: NIV, which included nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation or high-flow nasal cannula; and no respiratory support, defined as room air or low-flow nasal cannula at ≤2 L/min.
The primary outcome was the colonisation of oral and nasal microbiota at 5 days post birth, measured by colony-forming units per millilitre (CFU/mL), with colonisation defined as bacterial growth >10 CFU/mL.
The study included 100 preterm infants, with 50 in each group. Nasal microbial colonisation was observed in 56% (28/50) of the NIV group, significantly higher than the 28% in the no respiratory support group. No significant differences were found in oral colonisation. Adjusted binary logistic regression showed an association between NIV and increased risk of nasal colonisation (adjusted OR=2.91, 95% CI 1.12 to 7.58, p=0.028).
NIV in preterm infants was linked to a higher risk of nasal microbial colonisation. This finding suggests the need for further research and consideration of infection control strategies in the NICU.
本研究旨在评估新生儿重症监护病房（NICU）中，经鼻持续气道正压通气（NCPAP）与早产儿口腔和鼻腔微生物定植的关系。
前瞻性队列研究。
浙江大学医学院附属儿童医院 NICU。
纳入胎龄 28-35 周、出生后 24 小时内的早产儿。
根据呼吸支持方式对婴儿进行分类：NIV，包括 NCPAP、经鼻间歇正压通气或高流量鼻导管；无呼吸支持，定义为≤2 L/min 的空气或低流量鼻导管。
主要结局为出生后 5 天的口腔和鼻腔微生物定植，以每毫升菌落形成单位（CFU/mL）表示，定植定义为细菌生长>10 CFU/mL。
本研究纳入 100 例早产儿，每组 50 例。NIV 组中 56%（28/50）发生鼻腔微生物定植，显著高于无呼吸支持组的 28%。口腔定植无显著差异。调整后的二项逻辑回归显示，NIV 与鼻腔定植风险增加相关（调整后的 OR=2.91，95%CI 1.12-7.58，p=0.028）。
NIV 可增加早产儿鼻腔微生物定植的风险。这一发现提示需要进一步研究，并考虑在 NICU 中采取感染控制策略。
