浙江地区新生儿血培养病原菌分布及耐药性分析

目的 了解浙江地区新生儿血培养病原菌分布及其常见病原菌对抗生素的耐药情况。方法 对我院新生儿科5442例患儿入院时行血培养并以VTTEK全自动微生物分析仪进行菌株鉴定及药敏试验。结果 5442例新生儿血培养标本共检出病原菌301株，总阳性率为5．5％；其中革兰阳性菌267株，占88．7％，革兰阳性菌中以凝固酶阴性葡萄球菌为主，占革兰阳性菌的88．4％，占总分离率的78．4％。革兰阴性菌33株，占11．0％，革兰阴性菌以大肠埃希菌居多，占革兰阴性菌的36．4％，占总分离率的4．0％。药敏结果显示革兰阳性菌对青霉素G耐药率最高，其次为苯唑西林、头孢唑啉、氨苄西林／舒巴坦、红霉素。革兰阴性菌中大肠埃希菌、肺炎克雷伯菌ESBLs的检出率分别为41．7％、87．5％；这些菌株时环丙沙星、丁胺卡那霉素、左旋氧氟沙星、哌拉西林／他唑巴坦、亚胺培南的耐药率较低。结论 本地区新生儿血培养病原菌以革兰阳性菌为主，凝固酶阴性葡萄球菌是主要病原菌，其次为大肠埃希菌。对常用抗生素的耐药现象比较严重。

Analysis of Distribution and Antibiotic Resistance of Pathogens from Neonatal Blood Culture in Zhejiang Province

Objective To investigate the distribution and antibiotic resistance of pathogens isolated from neonatal blood culture in Zhejiang Province. Methods 5442 blood samples were cultured from the newborn ward of Children＇ s Hospital of Zhejiang University School of Medicine, VTTEK automicroscan was used for strains identification and drug sensitivity test. Results 301 pathogenic strains were isolated from 5442 specimens and the positive rate was 5.5%. Among them, 267 stuns were gram-pesitive bacteria （88.7%）, and the cesgulase negative staphylococcus was dominant （78.41%）. 33 strains were gram-negative bacteria （11.0%）, and the E. coli was most frequently isolated （36.4% of gTam-negative bacteria）. The results of drug sensitivity test showed that the resistance rate of gram-pesitive bacteria to Penicillin G was the highest, the next were Oxacillin, Cefazolin, Ampinicillin/Sulbaetam and Erythromycln. Among gTam-negative bacteria, the positive rates of E. coli and Klebsiella pneumoniae that produce Extent-spectrum β-lactmnases （ESBLs） were about 41.67% and 87.5%, respectively. And the resistance rates of them to Ciprefloxacln, Amikacin, Levofloxacin, Pipemcillin/Tazobactmn and Imipenem were rather lower. Conclusion Gram-pesltive bacteria were the main pathogen causing neonatal septicemia in Zhejiang Province. Among them, coagulase negative staphylococcus is the main cause, and E. coli follows. The situation of antibiotic resistance was serious.