[水中分娩后的水污染和感染率]。

A Thoni, N Zech, L Moroder, F Ploner
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引用次数: 17

摘要

目的:对产盆水中的病原菌进行检测,并比较常规分娩婴儿的感染率。方法:采用前瞻性研究方法,对300例水中分娩水中的细菌进行了检测。桶水采样两次:将桶内灌满自来水后取A样,送水后取B样。此外,儿科医生还记录了新生儿在住院期间感染的任何迹象。结果:A样品中军团菌占29%,铜绿假单胞菌占22%,肠球菌占18%,大肠杆菌占32%,大肠杆菌占8%。安装过滤系统后,不再检测到军团菌。铜绿假单胞菌仅在3%的样品中被发现。在B样品中,我们发现81%的大肠杆菌污染增加。在58%的样本中检测到明显的大肠杆菌负担。由于临床和生物化学怀疑开始感染,1.15%的水出生儿童(1215人中有14人)给予抗生素治疗。相比之下,2.30%的常规出生的新生儿(817例中有19例)接受了抗生素治疗。结论:产道内粪便明显以大肠杆菌和大肠杆菌为主,但也有少量的金黄色葡萄球菌。军团菌和假单胞菌对自来水的污染显然可以通过在分娩盆的供应软管中安装过滤系统来减少。水中分娩后的新生儿感染并不比常规分娩后更频繁。
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[Water contamination and infection rate after water births].

Objective: This study aimed at examining the water of the birthing tub for pathogenic germs and at comparing the infection rates of the children born conventionally.

Method: In a prospective study, the germs found in the water of 300 water births were determined . The tub water was sampled twice: sample A was taken after filling the tub with tap water, sample B after the water delivery. In addition, the paediatrician documented any signs of infection of the neonates during their hospital stay.

Results: The A samples contained Legionella in 29%, Pseudomonas aeruginosa in 22%, enterococci in 18%, colibacilli in 32% and Escherichia coli in 8%. After fitting a filter system, no Legionella was detected any more. P. aeruginosa was found in only 3% of the samples. In the B samples, we found an increased contamination by colibacilli in 81%. A marked burden with E. coli was detected in 58% of the samples. Due to a clinically an biochemically suspected beginning infection, 1.15% of the water-born children (14 out of 1,215) were given antibiotics. In contrast, 2.30% of the conventionally born neonates (19 out of 817) were treated with antibiotics.

Conclusion: It is evident that during the bearing-down phase faeces are discharged into the birthing tube and that the water is contaminated mainly by E. coli and colibacilli, but also slightly by Staphylococcus aureus. The contamination of the tap water by Legionella and Pseudomonas could clearly be reduced by installation of a filter system into the supply hose of the birthing tub. Neonatal infections were not more frequent after water births than after conventional deliveries.

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