摘要
目的探讨母婴同室病房新生儿皮肤感染的病原菌及其耐药情况，为l临床合理使用抗菌药物提供依据。方法对2009年1月至2010年12月北京市大兴区人民医院产科母婴同室病房206例发生皮肤感染的新生儿皮损分泌物进行细菌培养、鉴定，分析致病菌及其对抗生素的耐药性。采用卡方检验比较组间差异。结果研究期间共分娩新生儿9131例，均为母婴同室，发生皮肤感染206例，发生率2．3％。新生儿的皮肤感染类型有2种，其中新生儿脓疱疮192例（93．2％），脐炎14例（6．8％）。在所有患儿中，共检出病原菌154株，其中革兰阳性球菌95株（61．7％），革兰阴性杆菌59株（38．3％）。革兰阳性球菌以金黄色葡萄球菌最常见，占检出病原菌的29．2％（45／154），其次为表皮葡萄球菌、溶血葡萄球菌；头孢唑林、阿莫西林／克拉维酸及哌拉西林／他唑巴坦对葡萄球菌具有良好的抗菌活性，而青霉素、氨苄西林和红霉素等耐药率相当高。革兰阴性杆菌以阴沟肠杆菌最常见，占检出病原菌的12．3％（19／154），其次为大肠埃希菌、肺炎克雷伯菌。革兰阴性杆菌对青霉素类、氨基糖苷类、头孢菌素类抗生素耐药率较高，而对哌拉西林／他唑巴坦、氨苄西林／舒巴坦、碳青霉烯类和喹诺酮类敏感率高。结论母婴同室病房新生儿皮肤感染病原菌以革兰阳性球菌为主，金黄色葡萄球菌居于首位。检出细菌提示多重耐药现象严重，临床应及时根据药物敏感试验的结果调整抗生素。
Objective To investigate the pathogens and their drug resistance of neonatal skin infection in Maternal-Neonatal Unit to provide evidence for rational selection of antibiotics. Methods Secretions of skin lesions from newborns with skin infections delivered in Maternal-Neonatal Unit, Department of Obstetrics of Beijing Daxing Peoplers Hospital from Jan. 2009 to Dec. 2010 were collected, cultured and identified for bacterial serotype. Antibiotic resistances of pathogens were determined. Enumeration data was presented by frequency and rate. The difference between groups was compared with Chi square test. Results Two hundred and six newborn skin infection cases were diagnosed, which accounted for 2.3 % of all newborns （n = 9131） delivered in the hospital during the study period. Two types of skin infection were identified, impetigo （n = 192, 93.2%） and omphalitis （n=14, 6.8%）. Totally 154 pathogens were found, including 95 （61.7%） Gram positive cocci and 59 （38.3%） Gram-negative bacilli. The major pathogens among Gram-positive cocci were Staphylococcus aureus （ 45/154, 29.2%）, followed by Staphylococcus epidermidis and Staphylococcus haemolyticus. Staphylococcus was sensitive to Cefazolin, Amoxicillin/clavulanic acid and Piperacillin/tazobactam, while resistant to Penicillin, Ampicillin and Erythromycin. The major pathogens among Gram-negative bacilli were Enterobacter cloacae （19/154, 12.3%）, followed byEscherichia coli and Klebsiella pneumoniae. Drug resistance rate of Gram-negative bacilli was high in penicillin, aminoglycosides and cephalosporins, while they were sensitive to piperacillin/tazobactam, Ampicillin/sulbactam, carbapenems and Ouinolones. Conclusions Gram positive cocci are the main pathogens of neonatal skin infection in the Maternal-Neonatal Unit, and among which Staphylococcus aureus is the major pathogen. Multi-drug resistance is common in the identified pathogens. Attentions should be paid to use antibiotics reasonably according to drug sensitivity test.
出处
《中华围产医学杂志》
CAS
北大核心
2012年第8期469-473,共5页
Chinese Journal of Perinatal Medicine
基金
首都医学发展科研基金（2007-3201）
关键词
母婴同室
皮肤疾病
细菌性
革兰氏阳性球菌
葡萄球菌
金黄色
抗药性
细菌
婴儿
新生
Rooming-in care
Skin diseases, infectious
Gram-positive cocci
Staphylococcus aureus
Drug resistance, bacterial
Infant, newborn
