OBJECTIVE: Illness is associated with the carriage of abnormal flora (aerobic Gram-bacilli except E. coli) in the oropharynx and rectum. The aim of this study was to investigate whether carriage of abnormal flora is associated with increased risk of sepsis and septicemia in surgical newborn infants. METHODS: A 2-year prospective study was carried out on 94 consecutive newborn infants requiring parenteral nutrition (PN) for gastrointestinal abnormalities. Throat and rectal swabs were taken on day 1 of PN and twice weekly. Patients were divided into two groups: abnormal flora (AF; n = 41) and normal flora (NF; n = 53). Sepsis was defined as clinical features of generalized inflammation requiring blood culture. Septicemia was the combination of sepsis and positive blood culture. RESULTS: Among the infants carrying abnormal flora Pseudomonas and Enterobacter spp. predominated. Duration of PN (AF median 30 days; NF median 9 days), incidence of sepsis (AF 29%; NF 6%), and septicemia (AF 22%; NF 2%) were significantly greater in the group of infants with abnormal flora. Surveillance cultures allow the detection of a subset of infants on PN at high risk of sepsis and septicemia. The degree of gut dysfunction related to the severity of underlying disease determines the duration of PN and the development of abnormal flora. The association between abnormal carriage and increased risk of sepsis and septicemia may be because of the intestinal endotoxin pool known to cause liver impairment and consequent suppression of systemic immunity.
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机译：目的：疾病与口咽和直肠中异常菌群（除大肠杆菌以外的好氧革兰氏杆菌）的运输有关。这项研究的目的是调查携带异常菌群是否与手术新生儿的败血症和败血病风险增加有关。方法：一项为期2年的前瞻性研究针对94位连续胃肠道异常需要胃肠外营养（PN）的新生儿进行。在PN的第1天和每周两次进行咽喉和直肠拭子采集。患者分为两组：异常菌群（AF； n = 41）和正常菌群（NF； n = 53）。败血症定义为需要血液培养的全身性炎症的临床特征。败血症是败血症和阳性血液培养的结合。结果：在携带异常菌群假单胞菌和肠杆菌属的婴儿中。占主导地位。在菌群异常的婴儿中，PN的持续时间（AF中位数为30天； NF中位数为9天），败血症的发生率（AF 29％； NF 6％）和败血病（AF 22％； NF 2％）显着增加。 。监测培养可以检测出败血症和败血病高风险的PN婴儿。肠道功能障碍的程度与潜在疾病的严重程度有关，这决定了PN的持续时间和异常菌群的发展。异常运输与脓毒症和败血病风险增加之间的关联可能是由于已知的肠内毒素库会导致肝功能损害和随后的全身免疫抑制。
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