益生菌对机械通气新生儿呼吸道致病菌定植的影响

Effect of probiotics on respiratory tract pathogen colonization in neonates undergoing mechanical ventilation

摘要:

目的：研究口饲益生菌对机械通气的新生儿口咽、下呼吸道致病菌定植的影响。方法：采用随机对照的方法，将使用机械通气的新生儿分为益生菌组(n=82)和对照组(n=83)。 对照组给予常规治疗，益生菌组在常规治疗的基础上口饲益生菌，观察两组定植于口咽、下呼吸道的致病菌及呼吸机相关性肺炎（VAP）病原菌菌株数，并观察致病菌定植时间及VAP发生的时间。结果：益生菌组口咽部致病菌的菌株定植率低于对照组（35% vs 51%，P<0.05）；益生菌组口咽部、下呼吸道致病菌定植时间及VAP发生时间均较对照组晚，两组比较差异均有统计学意义（P<0.05）；在临床观察过程中未见益生菌的不良反应。结论：益生菌用于机械通气新生儿可以减少口咽部致病菌定植，并延迟口咽部、下呼吸道致病菌定植及VAP发生时间。

Abstract:

OBJECTIVE: To study the effect of mouth-fed probiotics on pathogenic bacteria colonization of the oropharynx and lower respiratory tract in neonates undergoing mechanical ventilation. METHODS: Randomized control method was employed to divide the neonates undergoing mechanical ventilation into probiotics (n=82) and control groups (n=83). The control group received routine treatment. The probiotics group was administered with oral probiotics in addition to routine treatment. The number of pathogenic bacteria colonized on the oropharynx and lower respiratory tract, and the number of the bacterial strain of ventilator-associated pneumonia (VAP) in the two groups were examined. The timing of the bacteria colonization and VAP occurrence were also examined. RESULTS: The probiotics group presented a lower bacterial strain colonization rate of the oropharynx pathogenic bacteria than the control group (35% vs 51%; P<0.05). The colonization time of pathogenic bacteria of the oropharynx and lower respiratory tract, and the time of VAP occurrence lagged behind in the probiotics group compared with that the control group (P<0.05). No adverse reaction caused by probiotics was found. CONCLUSIONS: Probiotics administration is effective in decreasing pathogenic bacteria colonization on the oropharynx, in postponing the pathogenic bacteria colonization on the oropharynx and lower respiratory tract and in delaying the occurrence of VAP in neonates undergoing mechanical ventilation.