Analysis of high-risk factors for neonatal asphyxia complicated with infectious pneumonia
Objective The high-risk factors for neonatal asphyxia complicated with infectious pneumonia were explored,in order to provide a basis for early clinical identification and intervention.Methods This study retrospectively analyzed the clinical data of 47 children with asphyxia complicated by infectious pneumonia admitted to our hospital.Specimens were collected from the children for pathogen identification and drug-sensitivity tests.Univariate and multivariate Logistic regression analysis methods were used to screen high-risk factors by comparing the clinical data of the children.Results Among the 47 children,a total of 53 strains of pathogenic bacteria were detected.Among them,58.49％were Gram-negative bacteria,mainly Escherichia coli,and 41.51％were Gram-positive bacteria,mainly Staphylococcus aureus and Streptococcus pneumoniae.The drug-sensitivity test showed that among the 31 Gram-negative bacteria,the highest resistance rate was to ceftazidime,reaching 51.61％,only 1 strain was resistant to meropenem,and no strain was resistant to amikacin and imipenem.The resistance rates of levofloxacin,ciprofloxacin,gentamicin,cefepime,and tobramycin were 38.71％,35.48％,32.26％,29.03％,and 25.81％respectively.Among the 22 Gram-positive bacteria,the highest resistance rate was to penicillin,which was 95.45％,and no strain was resistant to vancomycin.The resistance rates of amoxicillin,erythromycin,clindamycin,and gentamicin were more than 50％,which were 90.91％,72.73％,59.09％,and 54.55％respectively,while the resistance rates of tetracycline,levofloxacin,and ciprofloxacin were relatively low,which were 36.36％,31.82％,and 22.73％respectively.There were significant differences in multiple birth-related indicators such as gestational age at birth,Apgar score,birth weight,between the infection group and the control group,but there were no significant differences in gender,multiple pregnancy,and mode of delivery.Multivariate analysis showed that amniotic fluid contamination,endotracheal intubation,and severe asphyxia were independent risk factors for neonatal infectious pneumonia.In the mild asphyxia group,the pH value was(7.09±0.07),PO2 was(44.51±8.03)mmHg,CO2 was(52.65±15.87)mmHg,BE was(-7.18±2.60)mmol/L,and Lac was(5.35±1.75)mmol/L.In the severe asphyxia group,the pH was(6.99±0.11),PO2 was(36.41±8.12)mmHg,CO2 was(85.12±17.87)mmHg,BE was(-15.73±6.22)mmol/L,and Lac was(9.72±3.13)mmol/L.There were significant differences in the levels of pH,PO2,CO2,BE,and Lac between the two groups(P＜0.05).Pearson correlation analysis showed that pH,PO2,and BE were negatively correlated with the severity of neonatal asphyxia(P＜0.05),while CO2 and Lac were positively correlated with the degree of asphyxia(P＜0.05).Conclusion The distribution of pathogenic bacteria in neonates with neonatal asphyxia complicated by infectious pneumonia was mainly Gram-negative bacteria.Clinical treatment should consider their drug resistance and rationally select antibiotics.Early identification of risk factors such as amniotic fluid contamination,endotracheal intubation and severe asphyxia was of great significance for preventing neonatal infectious pneumonia.Sufficient attention should be paid to the blood gas analysis results of children,and the treatment plan should be adjusted in a timely manner to improve the prognosis of children.
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