喂养不耐受早产儿大便大肠埃希菌、粪肠球菌和肺炎克雷伯菌的数量变化

目的观察早产儿喂养不耐受肠道中大肠埃希菌、粪肠球菌和肺炎克雷伯菌的变化。方法采用实时荧光定量PCR技术，分别对15例喂养不耐受早产儿和15例喂养耐受早产儿（对照组）生后第一天，出现喂养不耐受，喂养不耐受恢复后大便标本中的大肠埃希菌、肺炎克雷伯菌和粪肠球菌进行定量分析。结果喂养不耐受组中大肠埃希菌的拷贝数对数值（lg copies／g）分别为2．62±0．22、5．47±1．28、3．04±0．70，对照组分别为2．56±0．19、2．82±0．4、2．80±0．39；肺炎克雷伯菌的拷贝数对数值（1gcopies／g）分别为4．37±0．22、6．56±O．27、4．17±0．27，对照组分别为4，35±0．22、4．19±0．14、4．15±0．25；粪肠球菌的拷贝数（copies／g）分别为79．17±93．46、42。84±47．57、101。68±43．78，对照组分别为70．16±78．41、740．05±657．71、104．57±38．39。出现喂养不耐受时，两组的3种细菌拷贝数比较差异具有统计学意义（P〈0．05），而出现之前和恢复后两组细菌拷贝数差异无统计学意义（P〉0．05）。结论喂养不耐受时大肠埃希菌、肺炎克雷伯菌数量显著增高，可能参与喂养不耐受的发生，而粪肠球菌降低，可能起保护作用。

The variation of Escherichia coli,Klebsiella pneumoniae and Enterococcus faecalis in preterm infants with feeding intolerance

Objective To observe the variation of Escherichia coli,Klebsiella pneumoniae and Enterococcus faecalis in preterm infants with feeding intolerance.Methods The amount of Escherichia coli,Klebsiella pneumoniae and Enterococcus faecalis in stool specimens at the first day(no feeding) after birth,when clinical manifestations of feeding intolerance appeared,and after the recovery of feeding intolerance were determined and compared by using the Real-time quantitative PCR between 15 feeding intolerance preterm infants and the control group including 15 feeding tolerance preterm infants.ResultsLogarithmic absolute value(lg copies/g) of Escherichia coli at above three timepoints were 2.62±0.22,5.47±1.28 and 3.04±0.70 in feeding intolerance group respectively,and 2.56±0.19,2.82±0.4 and 2.80±0.39 in control group respectively.Logarithmic absolute value(lg copies/g) of Klebsiella pneumoniae were 4.37±0.22,6.56±0.27 and 4.17±0.27 in feeding intolerance group respectively,and 4.35±0.22,4.19±0.14 and 4.15±0.25 in control group respectively.Absolute value of Enterococcus faecalis were 79.17±93.46,42.84±47.57 and 101.68±43.78 in feeding intolerance group respectively,and 70.16±78.41,740.05±657.71 and 104.57±38.39 in control group respectively.There were statistically signifcant difference between the feeding intolerance group and the control group when feeding intolerance occurred(P<0.05).Conclusion The number of Escherichia coli and Klebsiella pneumoniae was significantly higher if preterm infants appear feeding intolerance,which may be involved in the genesis of feeding intolerance.Enterococcus faecalis may play a protective role.