新生儿肺炎常见病原体及临床特征分析

目的：研究新生儿肺炎常见病原体及其耐药情况和相关临床特征。方法：回顾性调查分析导致新生儿肺炎的4种常见病原体（339株）耐药情况以及各病原体组间患儿的临床特征，其中185株分离自支气管分泌物，72株分离自血样本，82株在两种样本中培养同时阳性。结果：本研究发现474例病原体培养阳性新生儿中，金黄色葡萄球菌（21.9%）、大肠埃希菌（19.2%）、肺炎克雷伯杆菌（19.0%）和阴沟肠杆菌（11.4%）是新生儿肺炎最常见的病原体，感染金黄色葡萄球菌的新生儿的出生体重多正常，多在生后24 h后入院，而感染G-杆菌（尤其是肺炎克雷伯杆菌）的患儿则多见于低出生体重儿，且一般于生后24 h内入院。50%以上的G-杆菌对第2到4代头孢菌素耐药。结论：新生儿肺炎病原体以G-杆菌为主，且多见于低出生体重儿，发病时间一般较早。引起新生儿肺炎的G-杆菌对头孢菌素的耐药率较高。

Common pathogens and clinical characteristics of neonatal pneumonia

Objective To study common pathogens and their antibiotic susceptibility as well as clinical characteristics of neonatal pneumonia.Methods A retrospective study on neonatal pneumonia was performed.The study investigated antibiotic susceptibility of four common pathogens(339 strains) that caused neonatal pneumonia.Clinical characteristics of the newborns with pneumonia were analyzed.Of the 339 strains,185 were isolated from bronchial secretions,72 from blood samples,and 82 with positive results of both samples.Results Four hundred and seventy-four neonates with pneumonia presented positive results of bacterial culture.the most common pathogens Staphylococcus aureus(21.9%),Escherichia coli(19.2%),Klebsiella pneumoniae(19.0%) and Enterobacter cloacae(11.4%).The birth weight of newborns infected with Staphylococcus aureus was generally normal,and the time of hospital admission was later(after 24 hours of life).In contrast,the newborns with gram-negative bacterial infection,especially Klebsiella pneumoniae infection,had lower birth weights and early time of hospital admission(within 24 hours of life).Nearly more than 50% gram-negative bacteria were resistant to second,third and forth generation cephaloporins.Conclusions Gram-negative bacteria are predominant pathogens of neonatal pneumonia.Neonatal pneumonia caused by gram-negative bacteria is common in newborns with low birth weight and its onset time is relatively earlier.Gram-negative bacteria that cause neonatal pneumonia are highly resistant to cephaloporins.