四川省凉山州西昌地区新生儿败血症血培养检出菌及耐药性分析

目的 探讨四川省凉山州西昌地区新生儿败血症血培养病原菌分布及其常见病原菌对抗菌药物的耐药情况.方法 收集2005年5月至2010年10月在本院就诊的254例新生儿败血症患儿的临床病历资料,采取回顾性分析方法对经血堵养分离出的254株阳性菌株进行构成比及其对抗菌药物耐药状况分析(本研究程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准).结果 254株检出菌中,革兰阳性(G+)菌为237株,占93.3%,其中,以凝固酶阴性葡萄球菌(CNS)为主,占革兰阳性菌的82.3%(195/237),占总分离率的76.8%(195/254);革兰阴性(G)菌为17株,占6.7%,其中以大肠埃希菌居多,占总分离率的5.5%(14/254).本组检出率最高的3种G+病原菌(表皮葡萄球菌、溶血葡萄球菌、人葡萄球菌)及检出率最高的G-病原菌(大肠埃希菌)的药敏试验结果显示,G+菌(表皮葡萄球菌、溶血葡萄球菌、人葡萄球菌)对青霉素耐药率最高,其次为红霉素、氨苄西林、头孢唑啉、阿莫西林/克拉维酸、复方磺胺甲(口恶)唑(SMZ-TMP),对万古霉素、利福平敏感.G-菌(大肠埃希菌)对氨苄西林及头孢噻肟耐药率较高,其次为头孢唑啉、庆大霉素及氯霉素;对亚胺培南敏感性很高.结论 四川省凉山州西昌地区新生儿败血症的血培养检出病原菌以G+菌为主,CNS是主要G+病原菌,G菌则以大肠埃希菌为主.该病对常用抗菌药物的耐药现象比较严重.

Analysis of Distribution and Antibacterial Resistance of Positive Results of Blood Cultures in Newborn With Septicemia in Xichang City, Liangshan Yi Autonomous Prefecture, Sichuan Province

Objective To investigate distribution and antibacterial resistance of pathogens causing neonatal septicemia in Xichang City,Liangshan Yi Autonomous Prefecture,Sichuan Province.Methods A total of 254 blood samples of newborn with positive results of blood cultures from May 2005 to October 2010 were identified and their drug-susceptibility tests were done.The study protocal was approved by the Ethical Review Board of Investigation in human being of First People′s Hospital in Liangshan. Results Among 254 strains,237 strains(93.3%) were Gram-positive(G+) strains and 17 strains(6.7%) were Gramnegative(G-) strains.Among the G+ strains,coagulase negative Staphylococcus(CNS) accounted for 82.3%(195/237) and took the overall isolating rate of 76.8%(195/254).Escherichia Coli took the major part in the G-strains,which accounted for 5.5%(14/254) of the overall isolating rate.The top four pathogens detected from this study were Staphylococcus Epidermidis,Staphylococcus Haemolyticus,Staphylococcus Hominis and Escherichia Coli.Drug sensitivity results showed that G+ strains including Staphylococcus Epidermidis,Staphylococcus Haemolyticus and Staphylococcus Hominis had the highest resistance rate to penicillin,then,erythromycin,ampicillin,cephazoline,amoxicillin/clavulanic acid and Sulfamathoxazole and trimethoprim(SMZ-TMP),while all of them were sensitive to vancomycin and rifampin.Escherichia coli had relatively high resistance rate to ampicillin and cefotaxime,then cephazoline,gentamicin and chloromycin,but very sensitive to imipenem.Conclusions G+ strains are the mojor pathogens causing neonatal septicemia in Xichang city,Liangsha Yi Autonomous Prefecture,Sichuan Province.Among G+ strains,CNS takes the first place,among G strains Escherichia coli is at the first.The phenomenon of antibacterial resistance is quite common and severe.