新生儿败血症致病菌分布及耐药性分析

目的 研究新生儿败血症感染致病菌分布及耐药性情况，为临床合理用药提供理论依据。方法 通过医院信息管理系统对我院2015年4月~2018年4月在围产儿科住院的共111例新生儿败血症的临床资料进行回顾性分析，对其所采血培养结果进行分析。结果 111例新生儿败血症患儿共检出菌株113株，其中革兰氏阳性菌103株（91.15%），革兰氏阴性菌10株（8.85%），真菌检出（0%）。革兰氏阳性菌以凝固酶阴性葡萄球菌（表皮葡萄球菌58株、溶血性葡萄球菌12株、人葡萄球菌9株、沃氏葡萄球菌3株）、粪肠球菌、金黄色葡萄球菌为主，分别为82株（72.57%）、10株（8.85%）、7株（6.19%）；革兰氏阴性菌以大肠埃希菌为主，共7株（6.19%）。革兰氏阳性球菌是新生儿败血症的主要病原菌，其对青霉素、红霉素及苯唑西林耐药率高，对万古霉素、替考拉宁100.00%敏感。革兰氏阴性菌对氨苄青霉素舒巴坦、氨苄西林、复方新诺明耐药率高，对亚胺培南、美洛培南敏感。结论 根据血培养药敏结果，选择敏感抗菌药物，合理使用抗生素，可减少细菌耐药的发生，提高临床治疗效果。

Distribution and Drug Resistance of Pathogenic Bacteria in Neonatal Septicemia

Abstract:Objective To study the distribution and drug resistance of pathogenic bacteria in neonatal sepsis infection,and to provide a theoretical basis for clinical rational drug use.Methods The clinical data of 111 cases of neonatal sepsis hospitalized in perinatal pediatrics from April 2015 to April 2018 in our hospital were retrospectively analyzed by hospital information management system. The blood culture results were analyzed.Results A total of 113 strains were detected in 111 children with neonatal sepsis,including 103 Gram-positive bacteria(91.15%),10 Gram-negative bacteria(8.85%),and fungi detected(0%).The Gram-positive bacteria are mainly coagulase-negative staphylococci(58 strains of Staphylococcus epidermidis,12 strains of hemolytic staphylococcus,9 strains of Staphylococcus aureus,3 strains of Staphylococcus aureus),Enterococcus faecalis and Staphylococcus aureus.There were 82 strains (72.57%),10 strains (8.85%),and 7 strains(6.19%),respectively;Gram-negative bacteria were mainly Escherichia coli,with 7 strains (6.19%).Gram-positive cocci is the main pathogen of neonatal sepsis,which has high resistance to penicillin,erythromycin and oxacillin,and is sensitive to vancomycin and teicoplanin 100.00%.Gram-negative bacteria were highly resistant to ampicillin sulbactam,ampicillin and compound trimethoprim,and sensitive to imipenem and meropenem.Conclusion According to the results of blood culture susceptibility,selecting sensitive antibiotics and rational use of antibiotics can reduce the occurrence of bacterial resistance and improve the clinical treatment effect.