摘要
目的探讨近年来新生儿大肠埃希菌败血症的临床特点及耐药性变迁情况,为早期诊断及合理治疗提供依据。方法对2002年1月至2008年10月本院确诊的40例新生儿大肠埃希菌败血症的临床资料及药敏结果进行回顾性分析。结果新生儿大肠埃希菌败血症临床表现多样,以发热、黄疸等表现多见,75.7%的病例C反应蛋白异常。40例新生儿大肠埃希菌败血症中有12例并发化脓性脑膜炎。大肠埃希菌对阿米卡星、环丙沙星、头孢西丁的耐药率低,对亚胺培南未发现耐药,对常用的头孢菌素耐药及产超广谱β内酰胺酶率近年有明显增高趋势。同时大肠埃希菌所致的晚发型败血症较早发型者耐药率高。结论新生儿大肠埃希菌败血症临床表现非特异性,C反应蛋白检查对早期诊断有一定价值;此类败血症易并发化脓性脑膜炎。头孢菌素类抗生素耐药性上升显著。
Objective To study the clinical characteristics and recent changes of antibiotic resistance of Escherichia coli sepsis in neonates in order to provide guidance for early diagnosis and appropriate treatment for this disease. Methods There were 40 confirmed cases of neonatal septicemia caused by Escherichia coli in the Neonatal Intensive Care Unit of author＇s hospital from January 1,2002 to October 31, 2008, their clinical characteristics and results of antibiotic sensitivity were retrospectively analyzed. Results The clinical presentations of neonatal septicemia caused by Escherichia eoli were non-specific, fever and jaundice were common clinical signs. There were 75.7% of cases had abnormal level of C-reactive protein （CRP） and 12 cases had meningitis. It was found that the strains of Escherichia coli isolated had low resistant rates to amikacin, ciprofloxacin and cefoxitin; they were all sensitive to imipenem. It was also found that the percentage of antibiotic resistance of Escheriehia eoli isolated showed significant increase to the commonly used broad spectrum antibiotics like ampicillin and cephalosporins, and antibiotic resistance of beta lactamase producing enterobacteriaceae （ESBLs） was increasing significantly in recent years. Further more, the percentage of ESBLs positive and multi-drug resistant Escherichia coli were higher in neonates with late onset sepsis compared to those with early onset sepsis. Conclusion The clinical manifestations of neonatal sepsis caused by Escherichia coli are usually non-specific, CRP level is valuable for early diagnosis of sepsis; it is common for neonates with Escherichia coli sepsis to develop E-coli meningitis. The antimicrobial resistance rate of Escherichia coli is increasing rapidly in recent years ; cephalosporins are among the highest mainly because of the rising of ESBLs producing strains secondary to antibiotic abuse.
出处
《中国新生儿科杂志》
CAS
2009年第4期217-219,共3页
Chinese Journal of Neonatology
关键词
败血症
大肠杆菌
抗药性
Septicemia
Escherichia coli
Drug resistance
