2003-2005年新生儿感染常见致病菌及耐药性的变迁

目的了解本地区新生儿2003至2005年感染常见致病菌的种类及耐药的现状，以指导临床合理应用抗生素。方法收集我院新生儿科2003年1月至2005年12月收治的613份体液培养阳性（痰液、血液、分泌物、胃液等标本）的患儿资料，对常见检出菌及其耐药性的变迁情况进行分析。结果共检出40种613株病原菌，以革兰阴性杆菌为主约占57．6％，而肺炎克雷伯菌和大肠埃希菌分别位于前二位，其产ESBLs菌株检出率分别为78．1％和82．6％。药敏结果显示，常见致病菌对青霉素、第一、二代头胞类抗生素、红霉素类耐药性显著增加，但对第三代头胞类抗生素如头孢曲松、头孢噻肟（凯福隆）、头孢他啶（复达欣）及B内酰胺酶抑制剂复方制剂、碳青霉烯类、万古霉素等较敏感。产ESBLs菌仅对亚胺培南及B内酰胺酶抑制剂复方制剂敏感。结论革兰阴性杆菌特别是肺炎克雷伯菌和大肠埃希菌是新生儿感染主要病原菌，产ESBLs菌比例增加应引起高度重视。碳青霉烯类、哌拉西林／三唑巴坦和头孢哌酮／舒巴坦，可作为新生儿严重医院感染经验用药，应尽量根据药敏试验调整抗生素。     

Postbiotic Supplementation for Children and Newborn’s Health

It is now well known how the microbiota can positively or negatively influence humans health, depending on its composition. The microbiota’s countless beneficial effects have allowed it to be defined as a genuine symbiont for our species. In an attempt to positively influence the microbiota, research has focused on probiotics and prebiotics. Probiotics are viable beneficial bacteria of various strains. Prebiotics are specific substances able to favor the development of advantageous bacteria strains. Postbiotics are a new category of compounds capable of affecting the microbiota. According to the different definitions, postbiotics include both nonviable bacteria and substances deriving from bacterial metabolism. Postbiotics are particularly promising in pediatric settings, as they offer some advantages over probiotics, including the absence of the risk of intestinal translocation or worsening of local inflammation. For these reasons, their use in fragile population categories such as newborns, and even more prematures, seems to be the best solution for improving microbiota’s health in this population. This narrative review aims to collect the research conducted so far on postbiotics’ potential in the first stages of life.     

Ultrasound measurement of the corpus callosum and neural development of premature infants

Length and thickness of 152 corpus callosa were measured in neonates within 24 hours of birth.Using ultrasonic diagnostic equipment with a neonatal brain-specific probe,corpus callosum length and thickness of the genu,body,and splenium were measured on the standard mid-sagittal plane,and the anteroposterior diameter of the genu was measured in the coronal plane.Results showed that corpus callosum length as well as thickness of the genu and splenium increased with gestational age and birth weight,while other measures did not.These three factors on the standard mid-sagittal plane are therefore likely to be suitable for real-time evaluation of corpus callosum development in premature infants using cranial ultrasound.Further analysis revealed that thickness of the body and splenium and the anteroposterior diameter of the genu were greater in male infants than in female infants,suggesting that there are sex differences in corpus callosum size during the neonatal period.A second set of measurements were taken from 40 premature infants whose gestational age was 34 weeks or less.Corpus callosum measurements were corrected to a gestational age of 40 weeks,and infants were grouped for analysis depending on the outcome of a neonatal behavioral neurological assessment.Compared with infants with a normal neurological assessment,corpus callosum length and genu and splenium thicknesses were less in those with abnormalities,indicating that corpus callosum growth in premature infants is associated with neurobehavioral development during the early extrauterine stage.