摘要
目的探讨梅州市2019—2023年新生儿感染性疾病的病原菌分布特点和耐药情况,指导临床抗菌药物的使用。方法回顾性分析梅州市人民医院2019年1月至2023年12月诊治的新生儿细菌感染性疾病患儿的细菌培养和药敏结果,观察病原菌分布特点,分析常见病原菌对抗菌药物的耐药性。结果共收集到660株病原菌,主要标本来源为痰液434株(65.76%)、血液111株(16.82%)和脐分泌物或其他分泌物73株(11.06%)。其中革兰阴性菌占55.45%(366/660),以大肠埃希菌、肺炎克雷伯杆菌为主;革兰阳性菌占42.42%(280/660),以金黄色葡萄球菌、无乳链球菌为主。发现多重耐药菌共216株,排名前三位为产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、耐甲氧西林金黄色葡萄球菌(MRSA)和产ESBLs的肺炎克雷伯菌。大肠埃希菌、肺炎克雷伯菌对头孢呋辛、头孢噻肟耐药率较高,对头孢他啶、哌拉西林他唑巴坦、碳青霉烯类耐药率较低。金黄色葡萄球菌对青霉素耐药率为91.61%,无乳链球菌对青霉素均敏感,两者对利奈唑胺、万古霉素均敏感。结论新生儿细菌感染的主要致病菌是大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、无乳链球菌,多重耐药菌占比高,以产ESBLs细菌为主。临床上应根据细菌分布特点和耐药情况合理地选择抗菌药物。
Objective To explore the distribution characteristics and drug resistance of pathogenic bacteria in neonatal infectious diseases in Meizhou city from 2019 to 2023,and to guide the use of clinical antibacterial drugs.MethodsA retrospective analysis was conducted on the bacterial culture and drug sensitivity results of neonates with bacterial infectious diseases diagnosed and treated in Meizhou People's Hospital from January 2019 to December 2023.The distribution characteristics of pathogenic bacteria were observed,and the resistance of common pathogenic bacteria to antibacterial drugs was analyzed.ResultsA total of 660 strains of pathogenic bacteria were collected,of which 434 isonates(65.76%)came from sputum,111 isonates(16.82%)came from blood and 73 isonates(11.06%)came from umbilical secretions or other secretions.Gram-negative bacteria accounted for 55.45%(366/660),mainly Escherichia coli and Klebsiella pneumoniae.Gram-positive bacteria accounted for 42.42%(280/660),mainly Staphylococcus aureus and Streptococcus agalactiae.A total of 216 strains of multidrug-resistant bacteria were found,and the top three were extended spectrum beta-lactamases(ESBLs)-producing Escherichia coli,methicillin-resistant Staphylococcus aureus and ESBLs-producing Klebsiella pneumoniae.The resistance rates of Escherichia coli and Klebsiella pneumoniae to cefuroxime and cefotaxime were higher,and the resistance rates to ceftazidime,piperacillin-tazobactam and carbapenems were lower.The resistance rate of Staphylococcus aureus to penicillin was 91.61%.Streptococcus agalactiae was sensitive to penicillin,and both of them were sensitive to linezolid and vancomycin.ConclusionsThe main pathogens of neonatal bacterial infection are Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,and Streptococcus agalactiae.The proportion of multidrug-resistant bacteria is high,mainly producing ESBLs bacteria.Antibiotics should be rationally selected according to the distribution and drug resistance of pathogens.
作者
石惠玲
陈宏香
江栋昌
Shi Huiling;Chen Hongxiang;Jiang Dongchang(Department of Neonatology,Meizhou People's Hospital,Meizhou 514031,China)
出处
《中国医师进修杂志》
2025年第10期938-944,共7页
Chinese Journal of Postgraduates of Medicine
关键词
细菌感染
耐药性
病原菌
新生儿
Bacterial infections
Drug tolerance
Pathogenic bacteria
Newborn
