病原学快速检测在新生儿感染性肺炎中的应用

目的通过对病原学的快速检测,及时了解本院新生儿感染性肺炎的病原菌及耐药菌构成,指导临床合理使用抗生素。方法对368例住院患儿行痰涂片、咽拭子筛查、直肠拭子筛查,并与同期进行的痰培养结果比较。结果 368例痰涂片标本中阳性标本201例,阳性率为54.6%。其中革兰阳性菌75株,占37.3%;革兰阴性菌126株,占62.7%。368例痰培养标本中阳性标本183例,阳性率为49.7%。其中革兰阳性菌67株,占18.2%;革兰阴性菌116株,占31.5%。368例咽拭子标本中耐甲氧西林金黄色葡萄球菌阳性标本11株,阳性率为3.0%;产超广谱β-内酰胺酶菌阳性标本3株,阳性率0.8%。368例直肠拭子标本中超广谱β-内酰胺酶菌阳性标本28株,阳性率为7.6%;未查见耐甲氧西林金黄色葡萄球菌阳性标本。结论痰涂片的快速初筛与痰培养病原菌分类一致性较高,咽拭子及直肠拭子对耐药菌的筛查与痰培养结果有高度一致性,可以根据痰涂片、咽拭子及直肠拭子筛查结果快速、有依据地选用抗生素治疗新生儿感染性肺炎。

Fast Testing of Pathogen on Distribution and Drug Resistance in Infectious Pneumonia of Neonatal

Objective To analyze the distribution and resistance pattern of pathogen isolated from infectious pneumonia of neonatal within 2 hours of hospitalization by sputum smear, bacterial culture, throat swab and rectal swab,and to provide guidance for clinical diagnosis and treatment. Methods Sputum specimens were performed sputum smear and Gram＇s staining within 2 hours of admission and bacterial culture, throat swab and rectal swab were also performed from 368 newborns with pneumonia to find any difference among these methods.Results 368 pathogens were isolated from qualified samples,the positive rate of sputum smear was 54.6%,there were 75 strains of Gram-positive germ,126 strains of Gram-negativegerm.The positive rate was 49.7% in sputum culture.In the etiological resistant bacterial species,the positive rate of methicillin resistant Staphylococcus aureus was 3.0% in throat swab,comparison with sputum culture was 2.4%;the positive rate of extended spectrum beta-lactamase producing bacteria was 7.6% in rectal swab,comparison with sputum culture was 9.5%.Coneluslon There is a high coincidence rate between the results of sputum smear and bacterial culture;there is a high coincidence rate between the results of throat swab, rectal swab and bacterial culture on resistant bacteria;Taking sputum smear and monitoring the throat swab and rectal swab of infectious pneumonia of neonatal newly admitted has provided a early guidance for rational application of antibiotics.