摘要
目的探讨新生儿早发型败血症(EOS)病原菌分布及对抗生素的耐药情况。方法回顾性分析2009—2011年我院新生儿科收治的EOS患儿,根据患儿血培养及药敏试验结果,分析病原菌及其对抗生素的耐药性。结果研究期间我科共收治新生儿3040例,诊断败血症146例,占4.8%,其中EOS43例,占住院新生儿的1.4%,占败血症患儿的29.4%。病原菌中革兰阳性菌以金黄色葡萄球菌(16.3%)为主,其次为耐甲氧西林金黄色葡萄球菌、表皮葡萄球菌、无乳链球菌,均占9.3%;革兰阴性菌以大肠埃希菌(20.9%)为主,其次为肺炎克雷伯菌(9.3%)、鲍曼不动杆菌(4.6%)。除无乳链球菌对青霉素敏感外,余革兰阳性球菌对青霉素、苯唑西林、头孢曲松、克林霉素、红霉素耐药率均很高,但未发现对利福平、万古霉素耐药;革兰阴性菌对氨苄西林、哌拉西林、第一、二代头孢及不加酶的第三代头孢菌素耐药率高,但对头孢哌酮/舒巴坦、碳青霉烯类、喹诺酮类耐药率低。结论金黄色葡萄球菌、大肠埃希菌是新生儿EOS的主要病原菌,应根据其药敏结果使用抗生素。
Objective Discussion about the distribution of pathogenic bacteria and drug-resistant on the antibiotics observed in neonate early-onset sepsis （EOS）. Methods Retrospective study the cases of neonates who were diagnosed as EOS between 2009 to 2011 in our hospital. We carried out the germicuhure and drug sensitive test to the sputum and blood of patient, and investigated the pathogenic bacteria and drug-resistant on the antibiotics. Results During this period, our department totally received and cured 3040 neonates and 146 of them were diagnosed as sepsis. The incidence is about 4. 8%. Furthermore, 43 of those patients were early-onset septicemia. It was 29.4% of the total number and the incidence is 1.4%. For the pathogenic bacteria, G ＋ pathogenic bacteria are mainly composed of staphylococcus aureus （ 16. 3% ）, and secondly of meticillin resistant, staphylococcus epidermidis, and streptococcus agalactiae with the same percentage of 9.3%. G- pathogenic bacteria are mainly composed of escherichia coli （ 20. 9% ） , and of about 9.3% Klebsiella pneumoniae and 4.6% Acinetobacter baumannii. Except streptococcus agalactiae is sensitive to the penicillin, other G ＋ coccus have high drug-resistant on the penicillin, oxacillin, ceftriaxone, clindamycin and erythrocin. But no such resistant was observed for rifampicin, levofloxacin, linezolid and vancomycin. G- pathogenic bacteria has a high drug-resistant on penicillin, piperacillin, cefotaxime sodium, cefuroxime and cefoxitin, but a low resistant on cefoperazone sodium and sulbactam sodium, carbapenem and fluoroquinolones. Conclusions Staphylococcus aureus and Escherichia coli are the main pathogenic bacteria which induce the early-onset septicemia of neonate. It should use the correct antibiotics based on their drug sensitive result.
出处
《中国新生儿科杂志》
CAS
2013年第2期85-87,共3页
Chinese Journal of Neonatology
关键词
败血症
早发型
病原菌
药敏试验
婴儿
新生
Sepsis, early-onset
Pathogens
Drug sensitive test
Infant,newborn
