新生儿肺炎病原菌特点及不同严重程度患儿血清25(OH)D3、CRP差异性分析  

Pathogenic characteristics of neonatal infectious pneumonia and differential analysis of serum 25(OH)D3 and CRP levels in children with different severity levels

作　　者：赵淑艳[1] 刘文玉[2] 魏丽芳 王新森 ZHAO Shuyan;LIU Wenyu;WEI Lifang;WANG Xinsen(Anyang Vocational and Technical College,Anyang455000,Henan,China;Anyang District Hospital;Anyang Cancer Hospital)

机构地区：[1]安阳职业技术学院,河南安阳455000 [2]濮阳市安阳地区医院 [3]安阳市肿瘤医院

出　　处：《中国病原生物学杂志》2024年第4期472-476,共5页Journal of Pathogen Biology

基　　金：2022年度安阳市卫生健康委员会科技攻关项目(No.2022C01SF054)。

摘　　要：目的探析新生儿感染性肺炎患儿病原菌分布特点及不同严重程度患儿血清25(OH)D3、CRP差异性。方法选取86例新生儿感染性肺炎患儿为本次研究对象,同时选取同期40例健康新生儿为健康对照组。患儿于确诊12 h内采集痰标本,全自动微生物鉴定仪鉴定菌种。将86例患儿随机分为单一用药组和联合用药组,单一用药组患儿给予阿莫西林钠克拉维酸钾治疗,联合用药组患儿在单一用药的基础上联合注射头孢他啶治疗。治疗1周后,评价两组患儿的临床疗效。同时采集两组患儿粪便标本,采用肠道内细菌群分析方法检测患儿粪便样本中乳酸杆菌、双歧杆菌、肠球菌属细菌、肠杆菌属细菌的含量。根据患儿住院时临床肺部感染评分,分为重症组21例,轻症组65例。采集所有研究对象静脉血,使用高效液相色谱法检测血清25(OH)D3水平,使用速率散射免疫比浊法检测血清CRP水平。结果86例新生儿感染性肺炎患儿中,52例患儿细菌培养结果阳性,阳性率60.47%,共培养分离55株致病菌。革兰阴性菌39株,主要为肺炎克雷伯菌、大肠埃希菌。革兰阳性菌15株,主要为肺炎链球菌、金黄色葡萄球菌。真菌1株,为白色假丝酵母菌。经过抗生素治疗后,联合用药组患儿的治疗总有效率为90.70%,单一用药组患儿治疗总有效率为69.77%,差异有统计学意义(P<0.05)。联合用药组患儿的乳酸杆菌水平、双歧杆菌、肠球菌属细菌水平低于单一用药组和健康对照组,肠杆菌属细菌水平高于单一用药组和健康对照组,差异有统计学意义(P<0.05)。轻症组患儿的血清25-(OH)D缺乏率为56.92%(37/65),重症组患儿的血清25-(OH)D缺乏率为76.19%(16/21),健康对照组新生儿的血清25-(OH)D缺乏率为7.5%(3/40),三组新生儿的血清25-(OH)D缺乏率差异有统计学意义(P<0.05)。重症组患儿的血清25(OH)D3为(9.25±5.46)ng/mL,显著低于轻症组和健康对照组,血清CRP为Objective To explore the distribution characteristics of pathogens in children with neonatal infectious pneumonia and the differences in serum 25(OH)D3and CRP levels among children with different severity levels.Methods 86cases of neonatal infectious pneumonia admitted to our pediatric department were selected as the study subjects,while 40healthy newborns during the same period were selected as the healthy control group.Within 12hours of diagnosis,sputum samples were collected from the patient and bacterial species were identified by a fully automated microbiological identification instrument.86pediatric patients were randomly divided into a monotherapy group and a combination therapy group.The monotherapy group received treatment with amoxicillin sodium and potassium clavulanate,while the combination therapy group received combined injection of ceftazidime on the basis of monotherapy.After one week of treatment,the clinical efficacy of the two groups of children was evaluated.At the same time,two groups of fecal samples from children were collected,and the content of Lactobacilli,Bifidobacteria,Enterococcus bacteria,and Enterobacterium bacteria in the fecal samples of children was detected by gut microbiota analysis method.According to the clinical pulmonary infection score during hospitalization,the patient was divided into a severe group of 21 cases and a mild group of 65cases.The venous blood from all study subjects were collected,the serum 25(OH)D3levels were detected by high-performance liquid chromatography,and the serum CRP levels were detected by rate scattering immunoturbidimetry.Results Among 86cases of neonatal infectious pneumonia,52cases showed positive bacterial culture results,with a positive rate of 60.47%.A total of 55pathogenic bacteria were isolated through culture.39strains of Gram negative bacteria,mainly Klebsiella pneumoniae and Escherichia coli.15strains of Gram positive bacteria,mainly Streptococcus pneumoniae and Staphylococcus aureus.1fungal strain,which was a Candida albicans.After a

关 键 词：新生儿 感染性肺炎 肠道菌群 25-羟基维生素D 

分 类 号：R722.135[医药卫生—儿科]