论文部分内容阅读
目的探讨新生儿重症监护室(NICU)低出生体重儿直肠潜在致病菌定植的特点及不同喂养方式对定植的影响。方法选取2014年1月-2016年3月该院NICU患儿165例为研究对象,根据喂养方式分为肠外营养组(50例)、人工喂养组(68例)和母乳喂养组(47例)。纳入研究2周后应用直肠拭子取样,将标本接种于血琼脂平板、Mac Conkey琼脂培养基、沙氏葡萄糖琼脂培养基。细菌鉴定采用Vitek Two全自动鉴定仪。结果与母乳喂养组和人工喂养组相比,肠外营养组的胎龄、出生体重较小,产前应用类固醇激素的比例较高(P<0.05)。86.7%(143/165)的患儿有革兰氏阳性菌定植,60.6%(100/165)的患儿有革兰氏阴性菌定植。肠外营养组的革兰氏阳性菌、革兰氏阴性菌定植率均低于人工喂养组和母乳喂养组,母乳喂养组溶血葡萄球菌定植率低于肠外营养组和人工喂养组(P<0.05)。多因素Logistic回归分析显示,胎龄、出生体重、剖宫产、喂养方式是直肠革兰氏阳性菌、革兰氏阴性菌定植的独立危险因素。结论母乳喂养或人工喂养较肠外营养有更多的直肠潜在致病菌定植。
Objective To investigate the characteristics of colonization of potential pathogenic bacteria in neonates with low birth weight neonatal intensive care unit (NICU) and the effects of different feeding methods on colonization. Methods A total of 165 children with NICU from January 2014 to March 2016 in our hospital were enrolled in this study. They were divided into parenteral nutrition group (n = 50), artificial feeding group (n = 68) and breastfeeding group (n = 47) ). Two weeks after the study, rectal swabs were taken and samples were inoculated on blood agar plates, Mac Conkey agar medium, and Sabouraud agar medium. Bacteria identification using Vitek Two automatic identification device. Results Compared with the breastfeeding group and the artificial feeding group, the gestational age and the birth weight of the parenteral nutrition group were relatively small, and the proportion of steroid hormone prenatal administration was higher (P <0.05). Gram-positive bacteria were colonized in 86.7% (143/165) of the children and Gram-negative bacteria in 60.6% (100/165) of the children. Gram-positive bacteria and gram-negative bacteria colonization rates of parenteral nutrition group were lower than that of artificial feeding group and breast-feeding group, and the colonization rate of hemolytic Staphylococcus aureus in breast-feeding group was lower than that of parenteral nutrition group and artificial feeding group (P < 0.05). Multivariate Logistic regression analysis showed that gestational age, birth weight, cesarean section and feeding mode were independent risk factors for Gram-positive and Gram-negative colonization. Conclusion Breastfeeding or artificial feeding has more rectal potential pathogens colonization than parenteral nutrition.