摘要
目的探讨凝固酶阴性葡萄球菌（CNS）致新生儿败血症的病原学及耐药性现状，为临床诊断与治疗提供实验室依据。方法对139例CNS致新生儿败血症血培养的病原学及耐药性进行回顾性分析。结果218份血培养细菌阳性标本中，共分离出CNS139株，占63．8％；耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）70株，检出率为50．4％，MRCNS多药耐药现象严重，对磺胺甲嗯唑／甲氧苄啶的耐药率高达92．9％，对环丙沙星、庆大霉素、克林霉素的耐药率在57．1％～68．6％，与MSCNS相比差异有统计学意义（P〈0．01）；MRCNS与MSCNS对红霉素和青霉素的耐药率均〉80．0％，MRCNS对米诺环素的耐药率较低，为4．3％，未见耐万古霉素菌株。结论CNS已成为新生儿血液感染第1位的病原菌，检出率高且呈多药耐药；万占霉素仍是MRCNS的最佳药物；临床应根据血培养和药敏结果选用敏感抗菌药物，以减少耐药菌株产生，提高治疗效果。
OBJECTIVE To investigate the etiology and drug resistance of neonatal septicemia caused by coagulase- negative Staphylococcus （CNS）, to provide basis for clinical diagnosis and therapy. METHODS Totally 139 cases of CNS neonatal septicemia caused by the pathogen in blood culture and drug resistance were analyzed retrospectively. RESULTS A total of 139 strains of eoagulase negative Staphylococcus were isolated from 218 patients with positive blood culture samples of bacteria, with the detectin rate 63.80/oo. Among which, methicillin- resistant coagulase-negative Staphylococci （MRCNS） were 70 strains, accounting for 50. 4%, multi-drug resistance of MRCNS was serious, to trimethoprim-sulfamethoxazole, the resistance rate was 91. 3%, to ciprofloxacin, clindamyein, and gentamicin, the resistance rates were between 52.2% and 65.2%, which showed a significant difference to MSCNS （P〈0.01）. The drug resistant rates to erythromycin and penicillin were higher than 80% in all strains of MRCNS and MSCNS. The resistance rate to minocycline was lower than 4.3%. No strains resistant to vancomycin was found. CONCLUSIONS CNS has become the most common pathogen in newborns. The detection rate is high and shows multi-drug resistantee. Vaneomycin is the first choice for treatment of MRCNS. The choices of antibiotics for clinical therapy must be done according to the results of drug susceptibility test.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第5期1034-1036,共3页
Chinese Journal of Nosocomiology
关键词
新生儿败血症
凝固酶阴性葡萄球菌
耐药性
Neonatal septicemia
Coagulase-negative Staphyloeoccus
Drug resistance
