呼吸机相关肺炎的病原学和耐药性监测

目的探讨呼吸机相关肺炎(VAP)的病原菌分布及耐药性特征。方法前瞻性研究了103例机械通气患者237例次VAP的致病菌分布和耐药性状况，并对早发性和迟发性VAP的病原学构成进行了对比分析。结果共检出致病菌383株，革兰阴性细菌(GNB)占84．1％，其中非发酵菌占51．4％，肠杆菌科占32．6％，革兰阳性球菌占12．8％，其中MRSA和MRSE占6．5％，真菌占3．1％；前5位致病菌分别为铜绿假单胞菌(30．3％)、鲍氏不动杆菌(11．5％)、肺炎克雷伯菌(10．7％)、大肠埃希菌(7．6％)、金黄色葡萄球菌(6．8％)等；药敏结果显示这几类菌株的多重耐药现象严重，较为敏感的抗菌药物有亚胺培南／西司他丁、阿米卡星、哌拉西林／他唑巴坦、头孢他啶、头孢吡肟、头孢哌酮／舒巴坦、环丙沙星及替卡西林／克拉维酸等，革兰阳性细菌均对万古霉素敏感；迟发性VAP的混合培养比例显著高于早发性VAP。结论VAP的病原菌构成以GNB为主且呈现出多重耐药现象，适当的最初经验性抗菌治疗应依据于病原学和耐药性的监测结果。     

临床分离革兰阴性杆菌对亚胺培南耐药性的变迁

目的调查十堰市革兰阴性杆菌对亚胺培南的耐药率变迁。方法对2009年1月-2010年10月从住院患者各种临床标本中分离的革兰阴性杆菌药敏结果进行回顾性调查。结果共分离出革兰阴性杆菌4658株,其中肠杆菌科细菌占36.7%;非发酵菌占63.3%;分离率占前5位的病原菌分别是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌;肠杆菌科细菌对亚胺培南的耐药率为0.9%;嗜麦芽寡养单胞菌、洋葱伯克霍尔德菌、铜绿假单胞菌、鲍氏不动杆菌对亚胺培南的耐药率分别为100.0%、62.4%、30.5%、10.1%。结论亚胺培南对肠杆菌科细菌具有很强的体外抗菌活性,对非发酵菌的体外抗菌活性较差,铜绿假单胞菌、鲍氏不动杆菌对亚胺培南的耐药率呈较大幅度上升。     

Antibiotic and Heavy Metal Resistance in Bacteria Isolated from the Eastern Mediterranean Sea Coast

In this study it aimed to determine the microbial diversity, level of antibiotic resistance patterns and distribution of heavy metal resistance of bacterial isolates from the Eastern Mediterranean Sea coast. The resistance of 255 Gram-negative bacterial isolates to 16 different antibiotics and to 5 heavy metals was investigated. The most common strains isolated from all samples were Citrobacter koseri (9.0 %), Escherichia coli (8.2 %) and Pantoea agglomerans (8.2 %). Our results revealed a high incidence of resistance to ampicillin (74.0 %), streptomycin (70.0 %) and cefazolin (48.3 %). The multiple antibiotic resistance (MAR) index ranged from 0.2 to 0.75. Isolates showed tolerances to different concentrations of heavy metals. Our results show that the Eastern Mediterranean Sea coast has a significant proportion of antibiotic and heavy metal resistant pathogens, or opportunist Gram-negative bacteria, and these bacteria may result in a potential public health hazard.     

675例婴幼儿下呼吸道感染痰培养与药敏试验结果分析

目的调查小儿下呼吸道感染的致病菌特征及耐药性,为临床合理用药提供依据。方法对下呼吸道感染患儿的痰标本进行细菌培养并做药敏试验。结果共检出675份阳性标本,致病菌541株,总阳性率为80.2%,其中革兰阴性菌438株（占64.9%）,革兰阳性菌50株（占7.4%）,真菌53株（占7.9%）,主要致病菌依次为大肠埃希菌、肺炎克雷伯菌、白假丝酵母菌、铜绿假单胞菌、嗜麦芽窄食单胞菌、阴沟肠杆菌、人葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌。大肠埃希菌和肺炎克雷伯菌检出百分率分别为27.6%和21.2%。耐药率较高的抗生素为：肺炎克雷伯菌对派拉西林（96.1%）,大肠埃希菌为派拉西林（89.8%）,嗜麦芽窄食单胞菌对亚胺培南（100%）,铜绿价单胞菌对氨苄西林（100%）,阴沟肠杆菌对氨苄西林（86.3%）,金黄色葡萄球菌对青霉素（81.7%）。结论小儿下呼吸道感染病原菌以革兰阴性菌为主,且耐药谱广、耐药率高;其次是真菌。     

肿瘤患者医院感染革兰阴性杆菌的耐药性调查

目的 探讨肿瘤患者革兰阴性杆菌(GNB)医院感染现状及耐药性,为临床医师合理用药提供参考依据.方法 细菌培养严格按照《全国临床检验操作规程》进行;细菌鉴定采用法国生物梅里埃公司提供的API板条和软件系统;药敏试验采用K-B法,依据CLSI最新版本进行结果评价.结果 从医院肿瘤患者感染性标本中共分离出168株GNB,大多数GNB均表现出多药耐药性;铜绿假单胞菌(PAE)和鲍氏不动杆菌(ABA)泛耐药菌株检出率分别为11.1％、18.7％;耐亚胺培南PAE和ABA菌株检出率分别为13.3％、18.7％.结论 肿瘤患者医院感染GNB耐药性呈上升趋势,应采取综合性干预措施,遏制多药耐药菌医院感染.     

Airborne bacteria and fungi associated with waste-handling work

Abstract

Background: Municipal workers handling household waste are potentially exposed to a variety of toxic and pathogenic substances, in particular airborne bacteria, gram-negative bacteria (GNB), and fungi. However, relatively little is known about the conditions under which exposure is facilitated.

Methods: This study assessed levels of airborne bacteria, GNB, and fungi, and examined these in relation to the type of waste-handling activity (collection, transfer, transport, and sorting at the waste pre-processing plant), as well as a variety of other environmental and occupational factors. Airborne microorganisms were sampled using an Andersen single-stage sampler equipped with agar plates containing the appropriate nutritional medium and then cultured to determine airborne levels. Samples were taken during collection, transfer, transport, and sorting of household waste. Multiple regression analysis was used to identify environmental and occupational factors that significantly affect airborne microorganism levels during waste-handling activities.

Results: The “type of waste-handling activity” was the only factor that significantly affected airborne levels of bacteria and GNB, accounting for 38% (P?=?0·029) and 50% (P?=?0·0002) of the variation observed in bacteria and GNB levels, respectively. In terms of fungi, the type of waste-handling activity (R²?=?0·76) and whether collection had also occurred on the day prior to sampling (P<0·0001, R²?=?0·78) explained most of the observed variation. Given that the type of waste-handling activity was significantly correlated with levels of bacteria, GNB, and fungi, we suggest that various engineering, administrative, and regulatory measures should be considered to reduce the occupational exposure to airborne microorganisms in the waste-handling industry.     

Epidemiology of gram negative bacterial septicemias: data from a Tunisian hospital (1996-1998)

Gram-negative bacilli (GNB) septicemia are among the most serious infections encountered in the hospital since they generally occur on debilitated patients and are due to the multi-drug resistant bacteria. A retrospective study relating to 195 septicemia was carried out with an aim studying epidemiologic profile, predisposing factors, entry sites for micro-organisms, responsible GNB and their antibiotic susceptibility. GNB septicemia were mainly frequent in intensive care units (34%) and surgery (31%). Previous antibiotherapy, invasive procedures and surgical acts were the principal predisposing factors. The entry sites for micro-organisms remained unknown in 1/3 of the cases. The most common source of septicemia was the urinary tract infections. E. coli was the most frequent isolated bacteria (26%) in the community acquired spticemia whereas Klebsiella-Enterobacter-Serratia (KES), Acinetobacter and Pseudomonas were mainly encountered in nosocomial infections. Imipenem remained the most active betalactamin on GNB (2% of resistance) with amikacin (16% of resistance) among aminoglycosides. The rate of mortality was 18%. Hospitalization wards (intensive care units, surgery), entry sites unknown, septic shock syndrome were the main factors of prognosis. The development of immunology and molecular biology should improve the outcome of these infections but the preventive measures remain the most effective.     

2003～2008年医院细菌耐药性变化的分析

目的分析2003~2008年医院患者常见病原菌及其耐药情况,为临床合理应用抗菌药物提供支持。方法对医院2003年1月1日~2008年12月31日住院患者分离菌株及其对抗菌药物的耐药情况进行回顾性分析。结果2003~2008年医院共分离病原菌28 770株,其中革兰阴性杆菌19 967株,占69.4%,革兰阳性球菌8803株,占30.6%;所有分离病原菌中居前4位的为大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌和金黄色葡萄球菌;金黄色葡萄球菌和表皮葡萄球菌中耐甲氧西林菌株平均分别为71.1%和90.5%;革兰阳性球菌对万古霉素、替考拉宁的耐药性较低(5.0%);葡萄球菌属和肠球菌属均发现少数耐万古霉素和替考拉宁株;大肠埃希菌和肺炎克雷伯菌中产ESBLs株平均分别为56.0%和35.9%,其对抗菌药物的耐药率(32.7%~56.0%)高于非产ESBLs株(23.1%~46.7%);肠杆菌科细菌对碳青酶烯类的耐药性均很低(2.0%),其次为头孢哌酮/舒巴坦和阿米卡星;非发酵革兰阴性杆菌逐年上升,且耐药率(35.0%~60.0%)普遍高于肠杆菌科细菌,以对头孢哌酮/舒巴坦的耐药率最低(35.0%)。结论医院细菌耐药呈增长趋势,加强对金黄色葡萄球菌和非发酵菌如鲍氏不动杆菌的耐药性检测,对于合理选用抗菌药物和控制细菌耐药性产生十分重要。     

The Relationship of Breakfast Skipping and Type of Breakfast Consumption with Nutrient Intake and Weight Status in Children and Adolescents: The National Health and Nutrition Examination Survey 1999-2006

Background

National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited.

Objective

To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status.

Subjects

Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339).

Design

Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006.

Methods

Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferroni's correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers.

Results

Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index ≥95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05).

Conclusions

RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents.     

Home characteristics as predictors of bacterial and fungal microbial biomarkers in house dust

Background

Measurement of fungal and bacterial biomarkers can be costly, but it is not clear whether home characteristics can be used as a proxy of these markers, particularly if the purpose is to differentiate specific classes of biologic exposures that have similar sources but may have different effects on allergic disease risk.

Objective

We evaluated home characteristics as predictors of multiple microbial biomarkers, with a focus on common and unique determinants and with attention to the extent of their explanatory ability.

Methods

In 376 Boston-area homes enrolled in a cohort study of home exposures and childhood asthma, we assessed the relationship between home characteristics gathered by questionnaire and measured gram-negative bacteria (GNB) (endotoxin and C10:0, C12:0, and C14:0 3-hydroxy fatty acids), gram-positive bacteria (GPB) (N-acetyl muramic acid), and fungal biomarkers [ergosterol and (1→6) branched, (1→3) β-d glucans] in bed and family room dust.

Results

Home characteristics related to dampness were significant predictors of all microbial exposures; water damage or visible mold/mildew in the home was associated with a 20–66% increase in GNB levels. Report of cleaning the bedroom at least once a week was associated with reduced GNB, GPB, and fungi. Presence of dogs or cats predicted increases in home bacteria or fungi. The proportion of variance in microbial biomarkers explained by home characteristics ranged from 4.2% to 19.0%.

Conclusions

Despite their associations with multiple microbial flora, home characteristics only partially explain the variability in microbial biomarker levels and cannot substitute for specific microbial measurements in studies concerned with distinguishing effects of specific classes of microbes.     

全国细菌耐药监测网2021年肿瘤科患者分离细菌耐药监测报告

目的 了解肿瘤科患者感染常见病原菌的分布及耐药性,为临床合理选择抗菌药物提供科学依据。方法 选取2020年10月—2021年9月全国细菌耐药监测网的监测数据,应用WHONET 5.6软件对纳入统计的102 570株细菌数据进行分析。结果 肿瘤科患者主要标本来源为痰(38.3%)、尿(18.5%)和血(12.2%)。临床分离菌株中,革兰阳性菌居前3位的分别是金黄色葡萄球菌(35.9%)、粪肠球菌(13.6%)和屎肠球菌(10.6%)。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为25.0%。粪肠球菌和屎肠球菌对万古霉素耐药率分别为0.1%、0.8%。革兰阴性菌居前3位的分别是大肠埃希菌(30.6%)、肺炎克雷伯菌(21.7%)和铜绿假单胞菌(12.0%)。大肠埃希菌对头孢噻肟、头孢曲松耐药率超过50%,对碳青霉烯类耐药率约为1%。肺炎克雷伯菌对碳青霉烯类耐药率约为3%。耐碳青霉烯类铜绿假单胞菌检出率约为6%。结论 肿瘤患者临床分离细菌主要以革兰阴性菌为主,但耐药率不高。临床应继续加强抗菌药物合理使用,做好细菌耐药监测工作。     

全国细菌耐药监测网2014-2019年粪便标本细菌耐药监测报告

目的 了解全国粪便标本分离病原菌的菌群分布及耐药情况.方法 从2014-2019年全国细菌耐药监测网报告中提取粪便标本的相关数据(去除肠道正常定植菌群),分析肠道致病菌及其耐药率的变迁.结果 共分离菌株61 809株,居前3位的是沙门菌属(82.12％)、志贺菌属(8.08％)、弧菌属(4.03％),沙门菌属在每年粪便...     

呼吸内科下呼吸道感染患者病原菌构成及耐药性分析

目的明确呼吸内科医院获得性肺炎(CAP)、社区获得性肺炎(HAP)和医院保健性获得性肺炎(HCAP)病原菌构成及耐药情况,为临床抗菌药物的应用提供依据。方法采用回顾性监测的方法,调查2008年11月～2010年6月呼吸内科下呼吸道感染患者痰标本分离出的病原菌及耐药情况。结果共检出病原菌510株,其中革兰阴性菌373株(73.14%),以铜绿假单胞菌、克雷伯菌属、大肠埃希菌和鲍曼不动杆菌为主要病原菌;革兰阳性菌82株(16.08%),主要为肺炎链球菌和金黄色葡萄球菌;真菌55株(10.78%),以白假丝酵母菌为主。G-菌对美罗培南、亚胺培南、哌拉西林/他唑巴坦、阿米卡星、庆大霉素、妥布霉素、头孢吡肟、头孢他啶敏感性较好,耐药率﹤30.00%。G+菌对红霉素、克林霉素、环丙沙星、四环素、庆大霉素的耐药率﹥60.00%。真菌对酮康唑敏感率为100.00%。结论呼吸内科下呼吸道感染患者的主要病原菌为革兰阴性杆菌,进行细菌培养和药物耐药性分析,对合理选用抗菌药物具有重要意义。     

Seasonal variation in aerobic bacterial populations and endotoxin concentrations in grain dusts

Settled and respirable grain dust samples were collected at intervals over a 16-month period at two grain terminals on the lower Mississippi River. Total and gram-negative aerobic bacterial (GNB) populations, as well as endotoxin concentrations, were studied. Plate counts indicated that no viable bacteria were found to be present in the respirable samples. Endotoxin concentrations ranged from 0.0 to 6.4 ng (0.0 to 7.9 ng/m3 air) per respirable sample, indicating that bacteria were once viable in dust of respirable size or contamination occurred from larger, non-respirable particles. Numbers of bacteria from settled dusts, both total and GNB, remained relatively stable; however, the genera of the GNB populations varied. Enterobacter agglomerans was the predominant species in warm months, but not in winter. Pseudomonas and Klebsiella species increased in winter and decreased in summer. Other genera found were Citrobacter and Serratia. Endotoxin concentrations in settled dust samples ranged from 1.7 to 5.6 ng/mg dust.     

上海地区粒细胞缺乏伴肺部感染血液病患者呼吸道分离细菌及耐药性多中心回顾性研究

目的了解上海地区中性粒细胞缺乏(粒缺)伴肺部感染血液病患者呼吸道分泌物检出病原菌的分布及耐药情况。方法回顾性收集2012年1月—2014年12月上海市12所医院血液科粒缺伴肺部感染住院患者呼吸道分泌物分离菌株的临床资料、药敏结果,分析病原菌分布及其药敏数据,比较不同原发疾病病原菌分布之间的差异。结果共分离病原菌623株,其中革兰阳性菌138株(22.2%),革兰阴性菌485株(77.8%),非发酵菌占革兰阴性菌的60.2%(292株)。淋巴瘤患者标本中分离革兰阳性菌构成比(35.0%)高于急性髓系白血病和急性淋巴细胞白血病患者。居前5位的细菌分别是嗜麦芽窄食单胞菌(104株,16.7%)、肺炎克雷伯菌(88株,14.1%)、鲍曼不动杆菌(62株,10.0%)、铜绿假单胞菌(56株,9.0%)、金黄色葡萄球菌(48株,7.7%)。肺炎克雷伯菌对碳青霉烯类抗生素敏感率98%,铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为24.3%、8.9%,嗜麦芽窄食单胞菌对左氧氟沙星、米诺环素、复方磺胺甲口恶唑敏感率90%,鲍曼不动杆菌对阿米卡星、头孢哌酮/舒巴坦的耐药率低于10%。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为71.4%,未发现耐万古霉素、替考拉宁、利奈唑胺的金黄色葡萄球菌。结论粒缺伴肺部感染患者呼吸道分泌物分离菌株以革兰阴性菌占多数,其中非发酵菌占50%以上,细菌耐药率整体低于CHINET全国医院大样本监测结果。     

Changing trend of empirical antibiotic regimen: experience of two studies at different periods in a neonatal intensive care unit in Tehran, Iran

Bacterial sepsis is one of the most common causes of mortality and morbidity in neonates. It has been recognized a gradual change in spectrum of organisms responsible for neonatal sepsis. In this study we have evaluated changing trend of incidence and antibiotic susceptibility in neonatal late - onset sepsis (LOS) in 2-periods. This study is based on results of blood culture in neonatal late-onset sepsis, in 2--periods study throughout 12 - years. Neonatal LOS was defined as clinical signs suggestive of infection with a positive blood culture (B/C) after 72 hrs of birth. During first study (period: 1990-1992), the most common bacteremia in LOS was staphylococcus aureus (staph aureus) (34%). Overall gram- negative bacteria (GNB) were the predominant organism (66%). It was shown that 60% of GNB were resisted to gentamicin and 3% to amikacin, while in case of gram-positive bacteria (GPB); about 95% were resisted to ampicillin and 28% to cephalothin. In the second study (period: 2004-2007), the vast majority (56.6%) of septic cases were caused by GNB. The most common cause of late- onset sepsis was klebsiela p. (31%). The GPB were resistant to cephalothin (90%). There has been a dramatic increase resistance to cephalothin and aminoglycosides and 3rd -generation cephalosporins. The combination of cephalothin plus amikacin in suspected LOS was no longer the effective therapeutic regimen in our neonatal intensive care unit (NICU). Now, it seems the best choice for empiric antibiotic regimen in suspected LOS is the combination vancomycin plus amikacin. Constant surveillance is important to guide empirical antibiotic therapy and changes in trends.     

Health significance of Gram‐negative bacteria associated with waste‐fed tropical aquaculture system

Commercially important freshwater fish species, Cyprinus carpio, Oreochromia niloticus, Sarother‐odon galilaeus and Clarias anguillaris grown in aquaculture ponds receiving untreated sewage and animal faecal waste and in an untreated concrete tank were sampled to determine the presence of potentially pathogenic Gram negative bacteria to man. The resistance of some representative bacterial isolates to some commonly used antibacterial drugs were also determined. Fourteen bacterial species from nine genera, namely, Escherichia, Citrobacter, Enterobacter, Proteus, Salmonella, Serratia, Klebsiella, Pseudomonas and Aeromonas from both fish intestinal tracts and culture water samples were identified. Escherichia coli predominated in the sewage and animal manure‐treated ponds, while fluorescent Pseudomonas were common in the untreated pond. Pathogenic Salmonella spp. were isolated at a low frequency (1.32%) in fish from the sewage pond. Of the 577 bacterial isolates identified, 199 (34.49%) were resistant to at least one antibacterial drug.     

全国细菌耐药监测网2021年肾内科患者分离细菌耐药监测报告

目的 了解全国肾内科住院患者常见病原菌分布及耐药性。方法 对2021年全国细菌耐药监测网(CARSS)成员单位上报的所有肾内科住院患者分离菌及其耐药性进行分析。结果 肾内科住院患者共分离细菌122 203株,主要来源于尿、痰及血标本,占比分别为49.2%、16.7%和13.4%,其中,革兰阴性菌共81 994株(67.1%),革兰阳性菌共40 209株(32.9%)。最常见的前5位病原菌分别为大肠埃希菌(39 914株,32.7%)、肺炎克雷伯菌(12 695株,10.4%)、金黄色葡萄球菌(11 977株,9.8%)、铜绿假单胞菌(6 583株,5.4%)及屎肠球菌(5 821株,4.8%)。头孢曲松耐药的大肠埃希菌、肺炎克雷伯菌检出率分别为47.2%(15 704/33 272)、30.7%(3 091/10 070);耐碳青霉烯类的大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌检出率分别为1.0%(388/38 813)、8.2%(1 000/12 206)和4.8%(135/2 813)。鲍曼不动杆菌对亚胺培南、美罗培南、多黏菌素和替加环素的耐药率分别为27.6%(972/3 523)、...     

2021年甘肃省尿标本病原菌分布及耐药性

目的 分析2021年甘肃省医院临床尿标本分离病原菌的分布特点及耐药情况。 方法 收集甘肃省2021年细菌耐药监测网成员单位临床尿标本病原菌的耐药监测资料,根据临床实验室标准化协会(CLSI)2021版标准判断药物敏感性,应用WHONET 5.6软件进行数据统计分析。 结果 2021年尿标本中纳入分析的细菌共13 980株,革兰阴性菌占76.5%(10 692株),革兰阳性菌占23.5%(3 288株)。男性患者检出菌株占40.5%(5 656株),女性患者占59.5%(8 324株)。耐碳青霉烯类鲍曼不动杆菌的检出率较高,男性患者中＞30%。大肠埃希菌和奇异变形杆菌对氨苄西林的耐药率＞75%。铜绿假单胞菌对碳青霉烯类的耐药率＜10%。肠球菌对万古霉素、利奈唑胺和替考拉宁耐药率＜2%。粪肠球菌对氨苄西林的耐药率＜20%,屎肠球菌对氨苄西林的耐药率＞85%。 结论 不同性别患者尿标本检出病原菌分布及耐药率均有不同,临床可根据本地区耐药监测情况规范、合理使用抗菌药物。     

甘肃省某三级甲等妇幼保健机构新生儿重症监护病房病原菌种类分布与耐药性分析

目的分析甘肃省某三级甲等妇幼保健机构新生儿重症监护病房感染病原菌及耐药性,为临床治疗及感染防控提供科学依据。方法回顾性分析2016-2018年NICU各类标本所分离细菌的种类及主要菌种耐药性。结果NICU共分离病原菌414株,其中革兰阴性菌286株(69.08%),革兰阳性菌100株(24.15%),真菌28株(6.76%)。细菌培养标本共386例,主要为血液标本(194例,50.26%)。新生儿感染主要病原菌均存在多重耐药,革兰阴性菌对青霉素类耐药率普遍较高,对头孢曲松和头孢他啶的耐药性也应引起临床重视,但对氨基糖苷类及碳青霉烯类的敏感性较高;革兰阳性菌对青霉素和红霉素的耐药率较高,但对万古霉素和替考拉宁敏感性较高。结论新生儿重症监护病房病原菌以革兰阴性杆菌为主,耐药率较高,特别是肺炎克雷伯菌、鲍曼不动杆菌对多种抗菌药物耐药应引起重视,血液系统感染防控应作为NICU感染防控重点。