新生儿细菌感染病原菌构成及耐药分析

目的：探讨我院新生儿病区新生儿感染的病原菌分布特点及耐药情况，为临床合理使用抗菌药提供依据。方法：统计1996年1月至2007年1月我院新生儿病区新生儿细菌感染患儿细菌培养及药敏试验结果，对其病原菌分布及耐药情况进行分析。结果：我院2001年以前新生儿细菌感染检出菌中金黄色葡萄球菌占首位，其次为凝固酶阴性葡萄球菌（CNS）、大肠埃希菌；随着年代推移，CNS、肠杆菌属、铜绿假单胞菌等条件致病菌感染呈增加趋势。万古霉素、替考拉宁、利福平和诺氟沙星对葡萄球菌具有良好的抗菌活性，而青霉素、氨苄西林和红霉素等耐药率相当高；大肠杆菌对亚胺培南、诺氟沙星、头孢哌酮钠-舒巴坦、卡那霉素的敏感率较高，而对阿莫西林-克拉维酸、哌拉西林钠、头孢哌酮钠等的耐药率较高；阴沟肠杆菌对亚胺培南、头孢哌酮钠-舒巴坦、哌拉西林钠等药物的敏感率较高；假单胞菌对大多数抗菌药呈现耐药。结论：CNS、肠杆菌、铜绿假单胞菌等机会致病菌成为新生儿感染中常见的致病菌；新生儿常见病原菌对抗生素的耐药性越来越普遍，选择敏感的抗菌药物抗感染是有效治疗新生儿感染的关键。

Analysis of Composition and Drug Resistance of Pathogens in Neonatal Bacterial Infection

Objective:To investigate the composition and drug resistance of pathogens in neonatal bacterial infection in our hospital, and provide evidence for the selection of antibiotics in clinic. Methods: Summarized the statistics of the results of bacterial culture isolates and their drug sensitivity tests in neonatal bacterial infection in our hospital from 1996 to 2007,and investigated the composition and drug resistance of pathogens in neonatal bacterial infection. Results: Before 2001,the isolation of Staphylococcus aureus strain was highest in neonatal infection,and in turn was coagulase-negative Staphylococcus(CNS)and Escherichia coli. With time coming,the isolations of opportunistic pathogens such as CNS, Enterobacter, Pseudomonas aeruginosa increased. Most of Staphylococcus isolates were sensitive to vancomycin, teicoplanin, rifampin and norfloxacin, while were resistant to penicillin, ampicillin and erythromycin. Escherichia coli isolates were sensitive to imipenem, norfloxacin, cefoperazone/sulbactam and amikacin,and were poorly sensitive to amoxicillin/clavulanate, piperacillin and cefoperazone. Enterobacter cloacae isolates were sensitive to imipenem, cefoperazone/sulbactam, piperacillin and. Pseudomonas isolates were resistant to most of antibiotics. Conclution: Opportunistic pathogens such as CNS, Enterobacter, Pseudomonas aeruginosa have became the major cause of neonatal infection,and there is a trend of the increase of resistance to antibiotics,which suggests the importance to select the sensitive antibiotics for neonatal infection.