摘要
目的分析新生儿感染的病原菌分布特点、耐药性及危险因素,以降低新生儿感染的发生率及死亡率。方法选择526例感染患儿2780份送检标本进行细菌鉴定、药敏试验;对患儿临床资料进行回顾性研究,采用logistic回归分析感染可能的危险因素。结果新生儿感染主要菌种为肺炎克雷伯菌共139株,占43.99%,大肠埃希菌共57株,占18.04%,凝固酶阴性葡萄球菌共47株,占14.87%;以上菌株均为多药耐药,肺炎克雷伯菌与大肠埃希菌产ESBLs检出率为79.08%,耐甲氧西林凝固酶阴性葡萄球菌检出率为64.96%;低体重、羊水污染、气管插管、低蛋白血症、预防性应用广谱抗菌药物、使用激素等是新生儿感染的危险因素。结论了解病原菌的分布及耐药趋势,结合对危险因素的预防控制,有利于合理选择抗菌药物、制定有效的治疗方案,不仅可降低新生儿感染的发生率及死亡率,而且能够减少耐药菌株的产生。
OBJECTIVE To analyze clinical distribution, drug resistance characteristics of pathogens causing neonatal infections so as to reduce the incidence of the neonatal infections and the mortality. METHODS A total of 2780 specimens were obtained from 526 neonates with infections, the bacterial identification and drug susceptibility testing were performed, the clinical data of the neonates were retrospectively studied, and the logistic regression analysis was performed for the risk factors of the infections. RESULTS The main species of the pathogens causing the neonatal infections mainly consisted of 139 （43.99%） strains of Klebsiella pneurnoniae, 57 （18.04%） strains of Escherichia coli, and 47 （14. 87%） strains of coagulase-negative Staphylococcus. All of the isolates were multidrug-resistant. The detection rates of the ESBLs-producing K. pneumoniae and E. coli strains were 79.08%, and the detection rate of the methieillin-resistant coagulase-negative Staphylococcus was 64.96%. The low birth weight, amniotic fluid contamination, endotracheal intubation, prophylactic application of broad spectrum antibiotics, and use of glucocorticoid were the risk factors of the neonatal infections. CONCLUSION To aware the distribution and drug resistance trend of the pathogens combined with control of the risk factors is conductive to the reasonable use of antibiotics and development of the effective treatment programs, which can not only reduce the incidence of the neonatal infections and the mortality but also prevent the emergence of the drug resistant strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第2期382-384,共3页
Chinese Journal of Nosocomiology
关键词
新生儿感染
病原菌
耐药性
危险因素
Neonatal infection
Pathogen
Drug resistance
Risk factor
