摘要
目的分析新生儿血流感染的病原分布和耐药性,为临床感染控制选择抗生素治疗提供基础。方法回顾性分析新疆维吾尔自治区人民医院2018—2022年住院新生儿血培养标本结果,通过常规方法培养、分离、鉴定血培养阳性细菌,MIC方法测定药物敏感性,分析致病菌株的分布及其耐药性。结果2018—2022年住院新生儿共送检血培养标本2862份,阳性标本69例,新生儿血培养5年平均阳性率为2.41%。69例血流感染阳性患者,其中单一致病菌感染66例(95.65%),3例为复数致病菌感染(4.35%),共分离菌株72株;分离的革兰阴性菌38株,革兰阳性菌30株,真菌4株;革兰阴性菌以肺炎克雷伯菌和铜绿假单胞菌为多,分别占22.22%和16.67%。主要的革兰阴性菌对多种抗菌药物,特别是头孢菌素抗生素具有较高的耐药率,对阿米卡星完全敏感。革兰阳性菌检出以表皮链球菌和溶血链球菌为主,分别占15.28%和13.89%。对青霉素、红霉素、氨苄西林和苯唑西林表现出较高的耐药率,未检测到万古霉素耐药革兰阳性菌。血流感染阳性新生儿分离出4株真菌(2株白假念珠菌,1株曲霉菌和1株热带假丝酵母菌)。4株真菌均对5-氟胞嘧啶和两性霉素B敏感,1株白假念珠菌对氟康唑耐药,1株热带假丝酵母菌对伊曲康唑敏感,其余3株耐药。结论革兰阴性菌是新生儿血流感染的主要病原体,对多种抗菌药物均有较高的耐药率。了解细菌病原体的分布和耐药性对于指导抗生素的合理选择,降低新生儿死亡率和院内感染至关重要。
Objective To analyze the pathogenic distribution and drug resistance of neonatal bloodstream infections,and to provide basis for the selection of antibiotic therapy for clinical infection control.Methods The results of blood culture specimens from hospitalized neonates in the People′s Hospital of Xinjiang Uygur Autonomous Region from 2018 to 2022 were retrospectively analyzed.The distribution of pathogenic strains and their drug resistance were analyzed by culturing,isolating and identifying blood culture-positive bacteria by conventional methods and determining drug susceptibility by the MIC(minimum inhibitory concentration)method.Results From 2018 to 2022,a total of 2862 blood culture specimens were collected from hospitalized neonates,with 69 positive specimens.The 5-year average positive rate of neonatal blood culture was 2.41%.Of the 69 positive bloodstream infections,66(95.65%)were single pathogenic infections and 3(4.35%)were plural pathogenic infections.A total of 72 strains were isolated,among which 38 were Gram-negative,30 were Gram-positive and 4 were fungal strains.Gram-negative bacteria were predominant by Klebsiella pneumoniae and Pseudomonas aeruginosa,accounting for 22.22%and 16.67%,respectively.The major Gram-negative bacteria had a high rate of resistance to a variety of antibacterial drugs,especially cephalosporin antibiotics,and were fully susceptible to amikacin.Gram-positive bacteria detected were predominant by Streptococcus epidermidis and Streptococcus haemolyticus,accounting for 15.28%and 13.89%,respectively,which had a high rate of resistance to penicillin,erythromycin,ampicillin and benzocillin.No vancomycin-resistant gram-positive bacteria were detected.Four strains of fungi(two strains of Pseudomonas albicans,one strain of Aspergillus and one strain of Pseudomonas tropicalis)were isolated from neonates with positive bloodstream infection.All four strains were susceptible to 5-fluorocytosine and amphotericin B.One strain of Pseudomonas albicans was resistant to fluconazole.The strain of Pseudomonas tropicalis was susceptible to itraconazole,and the other three strains were resistant.Conclusions Gram-negative bacteria are the main pathogens of neonatal bloodstream infections and have a high rate of resistance to a variety of antimicrobial drugs.Understanding the distribution and resistance of bacterial pathogens is essential to guide the rational choice of antibiotics and reduce neonatal mortality and nosocomial infections.
作者
雷群
贾海英
王昌敏
LEI Qun;JIA Haiying;WANG Changmin(Clinical Laboratory Center,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang Uygur Autonomous Region,China.)
出处
《预防医学情报杂志》
CAS
2023年第11期1378-1383,共6页
Journal of Preventive Medicine Information
基金
新疆维吾尔自治区自然科学基金项目(项目编号:2019D01C103)。
关键词
血流感染
新生儿
病原菌分布
耐药性
bloodstream infections
neonates
pathogenic bacteria distribution
drug resistance
