112株新生儿败血症致病菌的分布及耐药性分析

目的:分析新生儿败血症的病原学分布及其耐药变迁情况,为临床及时明确病原、正确选用抗菌药物提供参考。方法:对苏州市立医院2009年6月—2012年6月间确诊的111例新生儿败血症病例的资料、血培养结果和药敏试验情况进行回顾性分析。结果:111例患者中检出病原菌112株,其中革兰阳性菌为78株(69.64%),革兰阴性菌为34株(30.36%);革兰阳性菌以凝固酶阴性葡萄球菌(CNS)为主,革兰阴性菌以肺炎克雷伯菌、大肠埃希菌为常见;革兰阳性球菌对青霉素、红霉素、苯唑西林的耐药性较高,对万古霉素、利奈唑胺未发现产生耐药;革兰阴性杆菌对氨苄西林产生耐药,对亚胺培南、阿米卡星、哌拉西林-他唑巴坦具有较高的敏感性。结论:CNS是导致新生儿败血症的主要病原菌,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和产超广谱β-内酰胺酶(ESBLs)肺炎的克雷伯菌、大肠埃希菌的比例呈上升趋势,临床应重视新生儿败血症的病原菌耐药性检测,根据血培养药敏结果合理选用抗菌药物。

Distribution and Resistance Analysis of 112 Strains of Pathogenic Bacteria of Neonatal Septicemia

Objective： To analyse the distribution of pathogens and the change of drug resistance in neonatal septicemia and to help us to correctly use antibiotics. Methods： The results of clinical data,blood culture and drug susceptibility test in 111 cases of neonatal septicemia were retrospectively analyzed. Results： A hundred and twelve stains were detected from 111 cases, with a result of Gram-positive accounting for 78 stains （69.64%） and Gram-negative accounting for 34 stains （30.36%）. The main strains were CNS of Gram-positive and K.pneumoniae, E.coli of Gram-negative; Gram-positive cocci demonstrated a strong resistance to penicillin, erythromycin, oxacillin and vancomycin（linezolid finds no resistance）; Gram-negative bacilli resistant to ampicillin and to imipenem, amikacin and piperacillin-tazobactam with high sensitivity. Condusion： CNS has become the main pathogenic bacteria of neonatal septicemia, MRCNS and K.pneumoniae, E. coli with ESBLs were increased. Much more attention should be paid to drug resistance detection and choice of sensitive antibiotics based on the drug sensitivity tests.