感染解脲脲原体的早产儿的临床特征和当前治疗方法

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-09-30 DOI:10.3390/children11101202
Zhenhai Zhang, Jian Wang, Wenwen Chen, Liping Xu
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引用次数: 0

摘要

背景:新生儿中解脲支原体的影响和对策仍存在争议。本研究旨在评估可预测呼吸道解脲支原体定植可能性的相关围产期因素,并分析受影响婴儿的后续临床过程,从而为其诊断、治疗和未来研究提供依据:这是一项回顾性观察研究,研究对象是胎龄(GA)小于 32 周的婴儿:结果:呼吸道解脲脲原体定植率为 25.8%(75/291),随着胎龄和出生体重(BW)的降低而增加。母体阴道解脲脲原体定植增加了新生儿解脲脲原体定植的风险,OR值为7.8(95% CI:3.1,20.0)。有解脲支原体定植的婴儿白细胞(WBC)计数更高,C反应蛋白(CRP)水平正常,机械通气断奶失败率更高(30.7% 对 17.1%,P = 0.014);他们患间质性肺炎(20.0% 对 5.6%,P < 0.001)和支气管肺发育不良(36.0% 对 13.4%,P < 0.001)的几率也更高;接受抗解脲支原体治疗的婴儿白细胞(WBC)计数更高,C反应蛋白(CRP)水平正常,机械通气断奶失败率更高(30.7% 对 17.1%,P = 0.014)。接受抗解脲原体治疗的婴儿GA值更低,体重更轻,呼吸综合征更严重。然而,在对GA进行调整后,呼吸系统表现的差异变得不显著:结论:GA和母体阴道解脲脲原体定植可用于预测新生儿呼吸道解脲脲原体定植。白细胞计数升高合并 CRP 正常是解脲支原体定植/感染的良好标志。传统的做法是,当婴儿出现呼吸状况恶化时,就开始抗解脲支原体治疗。考虑到 GA 是一个主要的中间变量,这种做法值得进一步研究。
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Clinical Characteristics and Current Treatment Modality of Preterm Infants with Ureaplasma spp. Infection.

Background: The impact of and countermeasures for Ureaplasma spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract Ureaplasma spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study.

Methods: This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks.

Results: The prevalence of respiratory tract Ureaplasma spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal Ureaplasma spp. colonization increased the risk of neonatal Ureaplasma spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with Ureaplasma spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, p = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, p < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, p < 0.001). Infants receiving anti-Ureaplasma spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA.

Conclusions: GA and maternal vaginal Ureaplasma spp. colonization could be used to predict neonatal respiratory tract Ureaplasma spp. colonization. An elevated WBC count combined with normal CRP is a good marker of Ureaplasma spp. colonization/infection. It is conventional practice to start anti-Ureaplasma spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable.

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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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