摘要
目的了解我院近5年新生儿败血症病原菌构成、分布情况及耐药特点,为临床治疗提供指导。方法收集2009年1月1日至2015年4月30日在我科住院确诊为新生儿败血症患儿血培养检出细菌情况及药敏试验结果,分析病原菌分布和耐药情况。结果 5年确诊新生儿败血症并分离血培养阳性菌共182株,大肠埃希菌43株(23.63%)、肺炎克雷伯菌37株(20.33%)、凝固酶阴性葡萄球菌31株(17.03%)、念珠菌16株(8.79%)及金黄色葡萄球菌15株(8.24%)是导致新生败血症的主要致病菌。早发型败血症主要病原菌为大肠埃希菌、肺炎克雷伯菌及凝固酶阴性葡萄球,晚发型败血症主要致病菌为肺炎克雷伯菌、凝固酶阴性葡萄球及念珠菌。革兰阴性菌对氨苄西林耐药率在95%以上,晚发型革兰阴性菌败血症主要以超广谱β-内酰胺酶(Extended-Spectrumβ-Lactamases,ESBL)阳性菌为主,对碳青霉烯类抗生素、头孢替坦及阿米卡星尚未发现耐药,对头孢唑林和头孢曲松耐药率在60%以上。葡萄球菌对青霉素耐药率在80%以上,对糖肽类抗生素尚未发现耐药。念珠菌对三唑类抗真菌药耐药率在40%左右,对两性霉素B及5-氟胞嘧啶尚未发现耐药。结论本院近5年新生儿败血症致病菌主要为大肠埃希菌、肺炎克雷伯菌及凝固酶阴性葡萄球菌,早发型败血症和晚发型败血症致病菌构成及细菌耐药谱具有差异,定期监测新生儿败血症致病菌及耐药性有助于临床合理使用抗生素治疗。
Objective To investigat the composition, distribution and drug resistance characteristics of the pathogens iso- lated from newborns with sepsis in our hospital in recent 5 years so as to provide evidence for clinical treatment. Methods A ret- rospective study of neonatal sepsis was conducted in West China Second University Hospital from January 1, 2008 to April 30, 2015. The results of pathogen and drug resistance were anylized. Results 182 stains were detected in recent five years. Esche- richia coli （ 43/182, 23.63% ）, Klebsiella pneumoniae （ 37/182, 20. 33% ）, Coagulase-Negative staphylococci （ 31/182, 17.03% ）, fungi （ 16/182,8. 79% ） and Staphylococcus aureus（ 15/182,8.24% ） were the five most common pathogens. Esche- richia coli, Kiebsiella pneumoniae and Coagulase-Negative staphylococci were the main pathogens causing early-onset of sepsis, while Klehsiella pneumoniae, CoagulaseoNogative staphylococci and fungi were the main pathogens for late-onset sepsis. The drug resistance of Gram-negative bacilli to ampicillin was above 95%. Extended-Spectrum β-Lactamases positive bacteria were the main pathogens of late-onset sepsis, and they demonstrated a strong resistance to Cefazolin and ceftazidime （ above 60% ）. They didn＇t show any resistance to imipenem, cefotan and amikacin. The drug resistance of Staphylococcus to penicillin were more than 80%. We didn＇t found any Gram-pesitve bacteria resistant to vancomycin. The fungi demonstrated about 40% resistance to triazole anti- fungal drugs. No fungi were resistance to amphotericin B and 5- fluorocytosine. Conclusion Escherichia coil, pneumonia Kleb- siella and coogulase negative staphylococci were the main pathogens causing neonatal sespis in rencent 5 years in our hospital. Pathogens and bacteria drug resistance were difference in Early-onset and late-onset sepsis. Regular monitoring of pathogens and drug resistance could be helpful for clinical rational use of antibiotics in neonatal sepsis.
出处
《四川医学》
CAS
2015年第8期1073-1077,共5页
Sichuan Medical Journal
关键词
新生儿
败血症
病原菌
耐药性
neonates sepsis
pathogen
drug resistance
