新生儿肺炎58例病原学分析  

Etiological Analysis of 58 Cases of Neonatal Pneumonia

作　　者：曾赛珍[1] 肖霓光[1] 周琼华[1] 钟礼立[1] 黄寒[1] 谢志平[2] 段招军[2] 高寒春[2] 张兵[1] 

机构地区：[1]湖南省人民医院,湖南长沙410005 [2]中国疾病预防控制中心与病毒生物技术国家工程研究中心,北京100052

出　　处：《医学临床研究》2011年第8期1438-1440,共3页Journal of Clinical Research

基　　金：[基金项目]湖南省自然科学基金资助项目（基金编号：07JJ5055）

摘　　要：【目的】了解新生儿肺炎病原学分布及临床特点。[方法]对2007年9月至2008年8月本院儿科医学中心住院临床诊断为新生儿肺炎58例患儿，采集鼻咽部分泌物，进行痰细菌培养及呼吸道病毒核酸检测，分析病原学分布及临床特点。【结果】58例患儿39例病毒检出阳性或痰细菌培养阳性，病原检出率67．2％，其中痰细菌培养及呼吸道病毒检出率均为46．6％。痰细菌培养以肺炎克雷伯菌（48．1％）最常见，病毒感染则以RSV（40．7％）及HRV（22．2％）为主。〉7d晚期新生儿较早期新生儿更易发生病毒感染（x^2=6．843，P＝0．009）；病毒感染忠儿较病毒检测阴性患儿更易合并心肌受损（r＝6．416，P＝0．011）。[结论]新生儿肺炎67．2％可明确病原，细菌以肺炎克雷伯菌为主，病毒则以RSV及HRV最常见。呼吸道病毒是新生儿肺炎尤其是晚期新生儿的重要病原，感染者常有心肌受损。[Objective] To understand the pathogen distribution and clinical characteristics of newborn pneumonia. [Methods] Totally 58 pediatric patients clinically diagnosed as newborn pneumonia in our hospital from Sept. 2007 to Aug. 2008 were enrolled in this study. Nasopharyngeal aspirate specimens were collected for bacterial culture and the detection of respiratory virus nucleic acid. The pathogen distribution and clinical characteristics were analyzed. [Results] Among 58 cases, the virus or sputum bacterial culture were positive in 39 cases, and the overall positive rate was 67.2%. The detection rate of both sputum bacterial culture and respiratory virus was 46.6%. Sputum culture showed that KlebsieUa pneumoniae （48.1%） was the most common. The main viruses were RSV（40.7%） and HRV（22. 2%）. The late newborns older than 7 days were easier to have viral infection than the early newborns （X^2 = 6. 843, P =0. 009）. The pediatric patients with viral infection were easier to be accompanied by myocardial damage than the pediatric patients without viral infeetion（z2 =6. 416, P =0. 011）. [Conclusion] The pathogens of 67.2% newborn pneumonia can be confirmed. The main bacterium is Klebsiella pneumoniae, and the main viruses are RSV and HRV. Respiratory viruses are the important pathogens of newborn pneumonia especially late newborn pneumonia. Infectious patients are usually accompanied by myocardial damage.

关 键 词：肺炎/微生物学 婴儿 新生 疾病 

分 类 号：R725.631[医药卫生—儿科]