血培养和超敏C反应蛋白联合检测新生儿败血症的诊断价值.docVIP

血培养和超敏C反应蛋白联合检测新生儿败血症的诊断价值 　　摘要：目的 分析新生儿血培养阳性分离菌与超敏C反应蛋白测定值的相关性，为临床鉴别病原菌和污染菌提供依据。方法 采用BACTEC9120血培养仪进行血培养，细菌鉴定使用ATB细菌鉴定仪。血清超敏C反应蛋白（Hs-CRP）采用免疫散射比浊法，对所有分离菌进行实验室评估和临床回访确定污染菌，病原菌的确定以临床诊断为最终标准。结果 267株新生儿血培养阳性结果中，以凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌为主。经证实，致病菌有163株，104株为污染菌，污染菌中以凝固酶阴性葡萄球菌、棒状杆菌属、芽孢杆菌属、微球菌属为主。污染菌组超敏C反应蛋白阳性结果显著低于感染组（P0.01）。结论 血清超敏C反应蛋白水平检测有助于鉴别血培养阳性的分离菌是致病菌还是污染菌，为临床使用抗菌药物提供可靠依据。 　　关键词：超敏C反应蛋白；血培养；新生儿败血症；致病菌 　　Abstract：Objective To analyze the correlation between the positive bacteria isolation of neonatal blood culture and the hypersensitive c-reactive protein（Hs-CRP） determination value and provide the basis for clinical identification of pathogenic bacteria and contaminated bacteria. Methods Using BACTEC9120 blood culture instrument for blood culture， bacteria identification using ATB bacteria identification instrument. The level of serum Hs-CRP is determined by immune scattering turbidimetry. For all the positive isolations， contaminated bacteria are identified by comprehensive laboratory evaluation and clinical return visit. The diagnosis of pathogenic bacteria is determined by the clinical diagnosis finally. Results Among the 267 neonatal blood culture positive strains， coagulant negative staphylococcus aureus， E.coli and klebsiella pneummoniae occupy a dominant position. It has been proved that 163 strains are pathogenic bacteria and 104 strains are contaminated bacteria. Most of the contaminated bacteria are coagulant negative staphylococcus bacteria， coryne bacterium genus bacillus genus and micrococcus. The value of Hs-CRP in contaminated bacteria group below the infection group significantly（P0.01）. Conclusion Serum Hs-CRP level detection is helpful in identifying pathogenic bacteria and providing reliable guidance for the clinical use of antimicrobial drugs. 　　Key words：Hypersensitive c-reactive protein（Hs-CRP）； Blood culture； Neonatal sepsis 　　新生儿败血症指新生儿患者细菌侵入血液循环，并在其中繁殖和产生毒素所造成的全身性感染，是新生儿常见的严重疾患，导致新生儿死亡的重要原因。由于新生儿尤其是早产儿常常不会像年长儿那样出现发热、白细胞升高等支持感染的指标，且