Sherman M P, Goetzman B W, Ahlfors C E, Wennberg R P
Pediatrics. 1980 Feb;65(2):258-63.
Tracheal aspirates were obtained from 320 newborns with respiratory distress and one or more perinatal risk factors for infection. Samples were obtained before 8 hours of age, either by direct aspiration or immediately following intubation. Twenty-five infants had bacteria present in the aspirate smear. In each case a pure culture of the organism suspected by smear morphology was grown. The same organism was isolated from blood in 14 of the 25 newborns suspected of having pneumonia. The remaining 11 infants had clinical courses, depressed mature neutrophil counts, and elevated band to total neutrophil ratios consistent with bacterial infection. Twenty-five infants without bacteria in the tracheal aspirate smear were randomly selected as a comparison group. Three of these infants had positive blood cultures, and one of the three also grew the same organism from the tracheal aspirate. The chest radiograph was abnormal in all infants but did not discriminate patients with or without pneumonia. We conclude that examination of the tracheal aspirate obtained within the first 8 hours of age is helpful in the early diagnosis of congenital pneumonia.
从320名有呼吸窘迫且有一个或多个围产期感染风险因素的新生儿中获取气管吸出物。样本在出生8小时前获取，通过直接抽吸或插管后立即获取。25名婴儿的吸出物涂片中有细菌。在每种情况下，通过涂片形态学怀疑的微生物均培养出纯培养物。在25名疑似患有肺炎的新生儿中，有14名从血液中分离出相同的微生物。其余11名婴儿的临床病程、成熟中性粒细胞计数降低以及杆状核与总中性粒细胞比例升高，符合细菌感染。随机选择25名气管吸出物涂片无细菌的婴儿作为对照组。这些婴儿中有3名血培养呈阳性，其中1名在气管吸出物中也培养出相同的微生物。所有婴儿的胸部X光片均异常，但无法区分有无肺炎的患者。我们得出结论，对出生后8小时内获取的气管吸出物进行检查有助于先天性肺炎的早期诊断。
