摘要
目的进一步了解2002～2006年大连市儿童医院新生儿科感染性肺炎病原菌构成及耐药情况，以指导临床合理应用抗生素。方法对2002年7月～2006年6月入住我科治疗的150例新生儿肺炎痰培养菌株134株进行回顾性分析，对不同年度及早期、晚期不同阶段新生儿肺炎病原菌构成进行比较分析。结果2002～2004年度62份标本中39份检出细菌，阳性检出率为63％。2005～2006年度88份标本63份检出细菌，阳性检出率为72％。检出菌株中两年度均以革兰阴性（G-）杆菌为主，分别为75％、66％。革兰阳性（G^＋）球菌2005～2006年度为28％，较2002～2004年度的10％有显著增加，差异有显著性。早期新生儿肺炎G^-杆菌中超广谱8内酰胺酶阳性（ESBLs^＋）占35％（7／20），晚期肺炎中仅占3％（3／73），差异有非常显著性。晚期新生儿肺炎G^＋球菌中金黄色葡萄球菌比例有增多趋势，而且逐年增加。药敏结果提示，多数菌株只对万古霉素敏感。结论近年无论是早期新生儿肺炎还是晚期新生儿肺炎病原菌仍以G^-杆菌为主，早期新生儿超广谱耐药杆菌感染较多。G^＋球菌肺炎比例有逐年增多趋势，特别是晚期新生儿肺炎。近年来金黄色葡萄球菌已成为晚期新生儿球菌肺炎的主要病原菌，而且药敏提示有耐药性增加趋势。
Objective To investigate the changes of pathogenic bacteria and drug tolerance in neonatal pneumonia during the period from July 2002 to June 2006, and to provide clinical reference for the reasonable antibiotic use. Methods One hundred and thirty four strains of bacteria isolated from 150 samples of pneumonia neonates in our department from 2002 to 2006 were analyzed retrospectively. The constituent ratio of pathogens was compared between different years and the ratio changes between early or late neonatal period were also studied. Results Thirty-nine bacteria strains were isolated from 62 samples of neonates during July 2002 - December 2004, and the positive rate was 62.9 % ; 63 strains were isolated from 88 samples during January 2005- July 2006 and the positive rate was 75 %. Among bacteria strains, Gram-negative bacillus accounts for 75 % during July 2002-December 2004 and 66 % during January 2005- July 2006. Gram-negative bacillus was still the main pathogenic bacteria. But the ratio of Gram-positive coccus was 28 % in 2005- 2006 period, Which was significantly higher than that in 2002- 2004 （9.6%）. The ratio of ESBLs（ ＋ ） bacillus was extremely higher in early neonates （7/20） than that in late neonates （3/73）. There was an increase in isolation of staphlococcus aureus in late neonates as well as in 2005 -- 2006 period. Drug-sensitive test showed that most of staphlococcus aureus were sensitive only to Vancomycin. Conelusion The main pathogenic bacteria of neonatal pneumonia is still Gram-negative bacillus both in early and late neonates in recent years. A higher isolation ratio of ESBLs（ ＋ ） bacillus is found among early neonates. There is an increasing trend in Gram-positive bacteria isolation rate in late neonates. Stapholococcus aureus comes to be the main pathogenic coccus in recent years, and drug-sensitive test shows an increase in drug tolerance.
出处
《中国小儿急救医学》
CAS
2008年第1期29-32,共4页
Chinese Pediatric Emergency Medicine
关键词
新生儿肺炎
细菌
耐药性
抗生素
Neonatal pneumonia
Bacteria
Drug-tolerance
Antibiotics
