新生儿肺炎病原菌分布及细菌耐药分析

目的 探讨新生儿肺炎病原菌分布特点及细菌耐药情况,以指导临床合理用药.方法对收住新生儿肺炎患儿的痰培养及药敏试验结果进行回顾性分析.结果 1 098份痰标本共检出病原菌234株,阳性率为21.31%,其中革兰氏阴性杆菌占62.39%,以大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌为主;革兰氏阳性球菌占37.61%,以金黄色葡萄球菌、表皮葡萄球菌为主;肠杆菌科中检出产超广谱β-内酰胺酶（ESBLs）菌53株,阳性率36.30%,金黄色葡萄球菌中耐甲氧西林葡萄球菌（MRSA）检出率58.62%;葡萄球菌对青霉素的耐药率均为100%,对万古霉素、利奈唑胺、替考拉宁敏感;产ESBLs的G-杆菌对第3代头孢菌素耐药率高达50%以上,对亚胺培南、美罗培南、阿米卡星耐药率＜4%.结论 新生儿肺炎的致病菌以G-杆菌为主,大肠埃希氏菌和金黄色葡萄球菌为常见致病菌;细菌对β-内酰胺类抗菌药物的耐药率较高.

Analysis of neonatal pneumonia pathogen distribution and bacterial resistance

Objective To study the pathogen distribution and analyze the drug resistance in neonatal pneumonia, and to provide the theoretical basis for clinical therapy. Methods The results of sputum culture and susceptibility test for neonatal with pneumonia in the department of neonatology were retrospectively analyzed. Results Two hundred thirty four plants pathogens were detected from one thousand and ninety eight sputum culture, the positive rate was 21.31% , with Gram negative bacteria accounting for 62.39% ; the main bacteria included Escheriehia coli, Klebsiella and Enterobacter cloacae. Gram positive bacteria accounted for 37.61%, the main bacteria included Staphylococcus aureus and Staphylococcus epidermidis ;53 plants gram negative bacilli produced ESBLs, the positive rate was 36.30% ;the Methieillin resistant Staphylococcus aureus＇ （MRSA） detection rate was 58.62% in Staphylococcus aureus; susceptibility results show staphylococcus strongly resistant to penicillin （100%）, but still sensitive to Quinupristin, Vancomycin, Lin ezolid and Teicoplanin; ESBLs producing gram negative bacilli was resistant to most of the antimierobial drugs, ESBLs producing G bacteria＂ s resistance rate was more than 50% to third generation eephalosporins, but sensitive to imipenem, Meropenem and Amika cin, the resistance rate was less than 4%. Conclusion Gram negative bacteria is the main pathogen to neonatal pneumonia, Esche richia coli and Staphylococcus aureus are the common pathogen, and bacterial is higher resistant to 15 lactam antibiotics.