摘要
目的了解和分析新生儿重症监护病房(NICU)早产儿肺炎克雷伯菌的医院感染发生、临床特点、易感因素及其细菌耐药性,以降低医院感染率及减少耐药菌的产生。方法收集NICU自2008年1月-2012年12月发生肺炎克雷伯菌医院感染的早产儿87例,对发生医院感染早产儿的临床症状、治疗方式、细菌耐药性以及转归等进行分析,数据采用SPSS13.0软件进行处理。结果共收治早产儿患儿1 581例,其中87例早产儿发生肺炎克雷伯菌感染,感染率为5.5%;87例早产儿中经气管插管机械通气42例占48.3%,外周静脉留置针使用率100.0%,静脉营养输注76例占87.4%;76例早产儿治疗好转出院,9例死亡,病死率为10.3%;共培养出105株肺炎克雷伯菌,其中痰液标本检出58株占55.2%,血液标本检出36株占34.3%;肺炎克雷伯菌对亚胺培南和哌拉西林/他唑巴坦的敏感率均为100.0%;共检出产超广谱β-内酰胺酶(ESBLs)42株,检出率为40.0%。结论肺炎克雷伯菌是NICU早产儿医院感染的重要致病菌,耐药菌比例较高,容易造成重症感染,应提高医院感染管理水平,避免滥用抗菌药物,降低医院感染率和减少耐药菌的产生。
OBJECTIVE To analyze the clinical features,predisposing factors and bacterial drug resistance of Klebsiella pneumoniae nosocomial infections in premature newborns of NICU.METHODS A total of 87 premature newborns（from Jan.2008 to Dec.2012）with nosocomial infections of K.pneumoniaein the NICU of our hospital were chosen for this study,their clinical data,including symptoms,treatment,bacterial drug resistance and outcomes were analyzed by SPSS13.0.RESULTS There were 87cases（5.5%）with nosocomial K.pneumoniae infection out of 1,581 premature newborns.As for the treatment for the 87 premature newborns,those who received the treatment of endotracheal intubation accounted for 48.3%（42cases）,venous indwelling needle100.0%and intravenous nutrition 87.4%（76cases）.There were nine cases of death（10.3%）and 76 cases were cured.A total of 105 strains of K.pneumoniae were detected,including 58strains（55.2%）from sputum and 36strains（34.3%）from blood samples.There were 42strains（40.0%）detected with extended-spectrum betalactamases（ESBLs）;all ESBLs positive K.pneumoniae were sensitive to imipenem and piperacillin/tazobactam.CONCLUSION K.pneumoniae is an important pathogen of nosocomial infection to NICU premature newborns.High drug resistant rate is easy to cause serious infection in NICU.Therefore,it is necessary to strengthen nosocomial infection control and curb the abuse of antibiotics,in order to reduce the incidence of nosocomial infection and prevent the occurring of new antibiotic resistant bacteria.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第19期4882-4884,共3页
Chinese Journal of Nosocomiology
基金
十二五国家科技支撑计划基金资助项目(2012BAI04B01)
关键词
新生儿重症监护病房
肺炎克雷伯菌
早产儿
医院感染
Neonatal intensive care unit
Klebsiella pneumoniae
Premature
Nosocomial infection
