新生儿下呼吸道感染病原学及耐药性检测

目的：调查该院新生儿重症监护病房（NICU）下呼吸道感染的病原菌及其耐药性。方法：对2005年1月至2006年12月该院NICU 1 173例下呼吸道感染新生儿的痰液标本经分离培养,做菌株鉴定和药敏试验。结果：共分离培养出病原菌707株,阳性率为60.3%。其中革兰阴性菌521株,占73.7%;革兰阳性菌106株,占15.0%;真菌80株,占11.3%。革兰阴性菌以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和肠杆菌为主,较敏感的抗生素为亚胺培南、环丙沙星、第四代头孢菌素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、丁胺卡那霉素,肠杆菌的敏感谱与之相似,但敏感率较低。革兰阳性菌中以金黄色葡萄球菌和其他凝固酶阴性的葡萄球菌(CNS）为主。金黄色葡萄球菌和其他CNS对青霉素的耐药率达到100%,对万古霉素、环丙沙星和哌拉西林/他唑巴坦敏感。结论： 该院NICU下呼吸道感染的病原菌以革兰阴性菌为主, 大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主要病原菌。

Distribution and drug resistance of pathogens in lower respiratory tract infection in neonates

Objective To investigate the epidemiological characteristics of pathogens and their antimicrobial susceptibility in neonates with lower respiratory tract infection(LRTI).Methods Sputum specimens for bacterial cultures were collected from 1 173 neonates with LRTL between January 2005 and December 2006.Antibiotic susceptibility tests were performed after bacteria had been identified.Results A total of 707 pathogenic strains(60.3%) were identified,including 521(73.7%) Gram-negative bacilli,106(15.0%) Gram-positive bacilli,and 80(11.3%) fungi.E Coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and enteric bacilli were common cultured Gram-negative bacilli.Most strains of Gram-negative bacilli were susceptible to meropenem,piperacillin/tazobactam,the fourth generation cephalosporin,cebfoperazone/sulbactam and amikacin.Staphylococcus aureus and coagula-negative staphylococci (CNS) were common in the cultured Gram-positive bacilli.Staphylococcus aureus and CNS were susceptible to vancomycin,ciprofloxacin and piperacillin/tazobactam but were resistant to Penicillin.Conclusions Gram-negative bacilli predominate the pathogens of LRTI in neonates.E Coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa are major pathogens.