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目的了解新生儿肺透明膜病(HMD)机械通气治疗中下呼吸道感染的常见病原菌和相应敏感药物.方法 对本院过去3年46例确诊为HMD行机械通气的患儿下呼吸道分泌物进行细菌培养,用细菌生化编码微量管法鉴定细菌,纸片扩散法做药敏试验.结果46例机械通气患儿,培养阳性率60.9%(28/46)机械通气3天以上培养阳性率100%(1/18).常见病原菌:肺炎克雷伯菌,假单胞菌,它们对常用抗生素耐药.对环丙沙星的敏感率分别为 92.3%(12/13)和66.7%(8/12).丁胺卡那霉素敏感率分别为39%(5/13)和50%(6/12).结论 机械通气HMD患儿易发生下呼吸道感染,机械通气3天以上时更为明显.常见的致病菌为肺炎克雷伯菌和假单胞菌等条件致病菌,对一般抗生素不敏感,可选用环丙沙星或丁胺卡那霉素.
Objective To understand the common pathogens and corresponding sensitive drugs of neonatal hyaline membrane disease (HMD) in the treatment of middle and lower respiratory tract infections.Methods 46 cases of lower respiratory tract secretions of children with HMD confirmed mechanical ventilation during the past 3 years were treated with bacteria The results showed that the positive rate of culture in 60 children with mechanical ventilation was 60.9% (28/46), and the positive rate of mechanical ventilation for more than 3 days was 100% ( 1/18) Common pathogens: Klebsiella pneumoniae and Pseudomonas, which are resistant to commonly used antibiotics and sensitive to ciprofloxacin are 92.3% (12/13) and 66.7% (8/12 ), And amikacin susceptibility rates were 39% (5/13) and 50% (6/12) respectively.Conclusion Lower respiratory tract infections are more likely to occur in children with mechanically ventilated HMD, especially when exposed to mechanical ventilation for more than 3 days. Common pathogenic bacteria Klebsiella pneumoniae and Pseudomonas conditions such as bacteria, insensitive to general antibiotics, ciprofloxacin or amikacin can be used.