新生儿早发型败血症10年病原菌变迁及药敏分析

目的　了解广东省佛山地区近 10年新生儿早发型败血症 (EONS)病原菌的变迁及药敏结果变化。方法　对 1993年 1月至 2 0 0 2年 12月广东佛山市妇儿医院 342例EONS病例血培养检出菌、药敏试验结果进行回顾性调查 ,将前后 5年两组资料对比分析。结果　共检出病原菌 38种 ,382株。后 5年与前 5年比较 ,检出构成比凝固酶阴性葡萄球菌 (CNS)、大肠埃希菌及肺炎克雷伯菌增高 ;金黄色葡萄球菌 (简称金葡菌 )及链球菌属降低。青霉素、苯唑青霉素对金葡菌 ,青霉素、氨苄青霉素、苯唑青霉素、红霉素和丁胺卡那霉素对CNS ,氨苄青霉素对大肠埃希氏菌的敏感率均显著下降 ;头孢唑啉的敏感率 10年来无显著改变 ;万古霉素对金葡菌、CNS敏感率 10 0 %。结论　CNS和大肠埃希菌为当前佛山地区新生儿早发型败血症常见的致病菌 ,常用抗生素对其敏感性显著下降。

Changes of pathogens and results of susceptibility test in early onset neonatal sepsis:a 10-year analysis

Objective To investigate changes of pathogens and antibiotic resistance in early onset neonatal sepsis(EONS).Methods A retrospective study of positive organisms of blood cultures and the results of antimicrobial suseptibility testing in 342 newborns with EONS was conducted,and the etiologic findings compared between January 1993 to December 1997 and January 1998 to December 2002.Results 38 kinds of pathogenic organisms and 382 strains were identified.The detection rates of coagulase-negative staphylococci(CNS),E.Coli and Klebasiella pneumoniae were increased.The rates of staphylococcus aureus and streptococci dropped.The susceptibilities of penicillin and oxracillin to staphylococcus aureus,penicillin,ampicillin,oxracillin,erythromycin and amikacin to CNS,Ampicillin to E.Coli were de-creased markedly.There was no significant change in the sensitivity of cefacidal.Vancomycin were totally susceptible to staphylococcus aureus and CNS.Conclusion CNS and E.coli are the most common pathogenic bacteria for EONS;the common antibiotic sensitivity to them has decreased obviously.