摘要
目的探讨新生儿早期肠道菌群的定植情况及影响因素。方法选取2021年9月~2022年9月青海省妇女儿童医院新生儿298例作为研究对象,在所有新生儿出生后第5~7 d采集新鲜粪便样本,采取全自动微生物分析仪对可疑菌落实施菌种鉴定,分离菌株(肺炎克雷伯菌、肠球菌及大肠埃希菌),计算细菌定植率。统计分析粪便培养结果,并比较不同胎龄、不同分娩方式、不同抗生素应用情况的新生儿细菌定植情况。结果(1)本组298例新生儿中,共检出肺炎克雷伯菌36株、肠球菌126株、大肠埃希菌171株;(2)足月分娩新生儿肺炎克雷伯菌定植率(12.70%)与早产新生儿(11.01%)比较,差异无统计学意义(P>0.05);足月分娩新生儿肠球菌定植率(35.45%)低于早产者(54.13%),大肠埃希菌定植率(70.37%)高于早产者(34.86%),差异有统计学意义(P<0.05);(3)顺产分娩新生儿肺炎克雷伯菌定植率(13.38%)与剖宫产者(10.64%)比较,差异无统计学意义(P>0.05);顺产分娩新生儿肠球菌定植率(35.03%)低于剖宫产者(50.35%),大肠埃希菌定植率(64.97%)高于剖宫产者(48.94%),差异有统计学意义(P<0.05);(4)未应用抗生素的新生儿肺炎克雷伯菌定植率(11.65%)与应用者(12.31%)比较,差异无统计学意义(P>0.05);未应用抗生素的新生儿肠球菌定植率(19.42%)低于应用者(54.36%),大肠埃希菌定植率(71.84%)高于应用者(49.74%),差异有统计学意义(P<0.05)。结论新生儿早期肠道菌群定植主要为肠球菌、大肠埃希菌,且其定植情况与是否应用抗生素、分娩方式及是否足月具有密切关联性,临床可根据上述因素对新生儿实施对应干预,从而改善新生儿肠道菌群定植情况。
Objective To investigate the colonization of intestinal flora in early neonates and its influencing factors.Methods 298 neonates in Department of Neonatology,Qinghai Women and Children’s Hospital from September 2021 to September 2022 were selected as subjects.Fresh fecal samples were collected from 5 to 7 days after birth of all neonates.The suspected bacteria were identified by automatic microbiological analyzer.The bacteria(klebsiella pneumoniae,enterococcus and escherichia coli)were isolated,and the bacterial colonization rate was calculated.The results of stool culture were statistically analyzed,and the bacterial colonization of neonates with different gestational age,different delivery methods,and different antibiotic application were compared.Results(1)Among 298 neonates,36 strains of klebsiella pneumoniae,126 strains of enterococcus and 171 strains of escherichia coli were detected.(2)There was no significant difference between the colonization rate of klebsiella pneumoniae in term neonates(12.70%)and premature neonates(11.01%)(P>0.05);The colonization rate of enterococci in full-term neonates(35.45%)was lower than that in preterm neonates(54.13%),and the colonization rate of escherichia coli(70.37%)was higher than that in preterm neonates(34.86%),with a statistically significant difference(P<0.05).(3)The colonization rate of klebsiella pneumoniae in neonates born naturally(13.38%)had no significant difference compared with those born by cesarean section(10.64%)(P>0.05);The colonization rate of enterococci(35.03%)was lower than that of caesarean section(50.35%),and the colonization rate of escherichia coli(64.97%)was higher than that of caesarean section(48.94%).The difference was statistically significant(P<0.05).(4)The colonization rate of klebsiella pneumoniae in neonates without antibiotics(11.65%)was not significantly different from that in neonates with antibiotics(12.31%)(P>0.05);The colonization rate of enterococcus neonatorum without antibiotics(19.42%)was lower than that of the users(54.36%),and the colonization rate of escherichia coli(71.84%)was higher than that of the users(49.74%),the difference was statistically significant(P<0.05).Conclusion The early intestinal flora colonization of neonates is mainly enterococcus and escherichia coli,and its colonization is closely related to whether antibiotics are used,delivery mode and term.The corresponding intervention can be carried out for neonates according to the above factors,so as to improve the intestinal flora colonization of neonates.
作者
王正岭
WANG Zheng-ling(Department of Neonatology,Qinghai Women and Children’s Hospital,Xining 810007,China)
出处
《中国实验诊断学》
2023年第3期315-318,共4页
Chinese Journal of Laboratory Diagnosis
关键词
新生儿
早期肠道菌群
定植
影响因素
neonate
Early intestinal flora
Colonization
Influence factor
