Extreme Climate Conditions Neonatal Infectious Pneumonia Occurrence Regularity And Etiology Research And The Change Of TNF-a、IL-6、

Purpose：1、 Research extreme climate conditions neonatal infectious pneumoniaoccurrence regularity and the correlation between neonatal infectious pneumonia andtemperature,air pressure and humidity.According to neonatal infectious pneumoniaclimate characteristics, take preventive measures to reduce the occurrence of neonatalinfectious pneumonia under the extreme climate conditions.2、 Discuss neonatal pneumonia pathogen distribution and drug resistancesituation, guide clinical use of antibiotics.3、Test the expression of tumor necrosis factor (TNF-a), interleukin-6(IL-6) andsoluble interleukin-2receptor (sIL-2R) in infectious pneumonia neonatal serum, andanalyze the correlation between the three, from an immunological perspective fordefinitive diagnosis neonatal pneumonia and provide a reliable basis.Methods：1、Collected the meteorological data from2008September to2010August fromthe Provincial Meteorological Bureau,a year climate is divided into of winter andspring type (November to February), summer (June to August), transition seasons(March to May and September to October). Discuss the relationship between neonatalinfectious pneumonia morbidity and mortality and seasons,and analysis thecorrelation between temperature, air pressure, humidity and the occurrence ofneonatal infectious pneumonia.2、Applicate the America’s WalkAway96microbial identification system identifybacteria and drug sensitivity test and the Super broad-spectrum beta-lactamases(ESBL) test.Analysis neonatal infectious pneumonia bacterial culture and drugsensitivity results.3、Choice diagnosed neonatal infectious pneumonia with no complications as theobject of study in our hospital from2008September to2010August. Sick childrenwere extracted two milliliter venous blood on the day of admission or onset, through enzyme-linked immunosorbent assay (ELISA) test tumor necrosis factor-a (TNF-a),interleukin-6(IL-6) and soluble interleukin2receptor (sIL-2R) in serum, discuss thecorrelation between the TNF-a, IL-6, sIL-2R, and analysis the relationship betweenthe three.Results：1、Neonatal infectious pneumonia occur with a certain rule under the extremeclimate, its morbidity related to the seasons, the highest in winter and spring,transition seasons is the second, the lowest in summer,the difference was statisticallysignificant (x2=19.366, P<0.01);Its mortality related to the seasons too, the highest inwinter and spring, transition seasons is the second, the lowest in summer,thedifference was statistically significant (x2＝9.918，P＜0.01);Neonatal pneumoniamorbidity and monthly average temperature showed a negative correlation（r=-0.751，P＜0.05);neonatal pneumonia morbidity and mean monthly air pressure are negativerelated（r=0.711，p＜0.05);neonatal pneumonia morbidity and monthly averagehumidity are not statistically significant（r=0.043，p＞0.05).2、Pharyngeal swab have75cases were positive in196cases of pneumonia,thepositive rate of38.3%.Detection of81strains of pathogenic bacteria,84%forGram-negative bacteria, mainly pneumonia Cray bacterium, Escherichia coli. Grampositive bacteria accounted for16%, mainly for Staphylococcus aureus,Staphylococcihaemolyticus.Gram negative bacterium to ampicillin, piperacillin, cephalosporinantibiotic resistance rate are high,to imipenem,piperacillin/tazobactam are sensitive.Gram positive bacteria to penicillin,ampicillin,cefazolin,cleocin, erythromycin resist-ance rate are high, only to clindamycin, vancomycin are sensitive.3、The test group TNF-a level21.92±9.16, control group TNF-a level5.73±1.69,there were statistically significant between the two groups (t=9.733, P<0.01); the testgroup IL-6level25.98±12.57, control group IL-6level2.15±0.76, there werestatistically significant between the two groups (t=10.691, P<0.01); the test groupsIL-2R level1694.75±524.80, control group sIL-2R level517.41±175.73, there werestatistically significant between the two groups (t=11.686,P<0.01)；TNF-a and sIL-2R,TNF-a and IL-6, IL-6and sIL-2R analysis showed a positive correlation（r=0.986，P＜0.01；r=0.890，P＜0.01；r=0.857，P＜0.01）. Conclusion：1、Neonatal infectious pneumonia occur with a certain rule under the extremeclimate conditions, its morbidity and mortality related to the seasons, the highest inwinter and spring, transition seasons is the second, the lowest in summer, this toprevent and reduce the occurrence of neonatal pneumonia has a guiding significance.2、Neonatal pneumonia morbidity and monthly average temperature showed anegative correlation, that the lower the temperature the more easily lead to theoccurrence of neonatal infectious pneumonia; neonatal pneumonia morbidity andmean monthly air pressure are positive related, that the higher the air pressure moreprone to infection of the newborn pneumonia; neonatal pneumonia morbidity andmonthly average humidity have no statistically significant,but the humidity havecertain effect on neonatal infectious pneumonia.3、Neonatal pneumonia pathogenic microorganisms priority to Gram-negativebacteria, for most of the antibiotic resistance, so we should choice the antibioticsreasonably, so as not to affect the treatment or delays due to worse.4、TNF-a, IL-6, sIL-2R in infectious pneumonia neonatal serum are higher thanthe control group, suggest that TNF-a, IL-6and sIL-2R in neonatal infectiouspneumonia play a role, for the diagnosis of neonatal infectious pneumonia provide areliable basis.5、TNF-a and sIL-2R, TNF-a and IL-6, IL-6and sIL-2R analysis showed apositive correlation, suggesting that TNF-a, IL-6and sIL-2R interact in neonatalpneumonia immune process, aggravated the severity of neonatal pneumonia.