摘要
目的了解新生儿感染性肺炎病原菌构成及其耐药性和常见菌耐药表型,为临床正确诊疗、合理选用抗生素提供依据。方法对湖南省儿童医院各新生儿科收治的疑为感染性肺炎患儿,无菌取痰进行普通培养和高渗培养,用VITEK2compact鉴定细菌、进行药物敏感试验、耐药酶检测和耐药表型分析。结果4 230份标本获需氧菌1 697株,阳性率40.12%:其中革兰阴性杆菌1 232株,占72.59%,革兰阳性球菌429株,占25.27%,其它菌种36株,占2.12%。458株产ESBL菌中肺炎克雷伯菌302株、大肠埃希菌94株。同时显示:革兰阴性杆菌对左氧氟沙星、头孢替坦、哌拉西林/他唑巴坦和亚胺培南较敏感,革兰阳性球菌对头孢噻肟、头孢哌酮、哌拉西林、头孢呋辛、万古霉素较敏感。结论新生儿感染性肺炎病原菌以革兰阴性杆菌为主,且有上升的趋势。加强病原菌检测,合理使用抗生素,防止耐药菌株的产生。
Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia, and to provide a therapy reference for clinical doctor to choose reasonable antibiotics and treat in time. Methods Taking expectoration from trachea in condition of asepsis to conduct general and high osmosis culture in suspected neonatal infectious pneumonia cases of Hunan Provincial Children＇ s Hospital. Identifying bacteria by Api system and performing drug- sensitive test. Results Totally 1,697 （40.12%） strains of aerobic bacteria were isolated from the 4,230 specimens, 1,232 （72.59%） were gram negative bacilli, 429 （25.27%） were gram positive cocci, and 36 （2.12%） were other bacteria. Among 458 ESBL- producing isolates, 302 strains were Klebsiella pneumoiae and 94 strains were Escherichia coli. The results showed that gram- negative bacilli were sensitive to levofloxacin, cefotetan, piperacillin/tazobactam, and imipenem, while gram- positive cocci were sensitive to cefotaxime, cefoperazone, piperacillin, cefuroxime, and vancomycin. Conclusions Gram- positive cocci are the main bacteria in neonates with infectious pneumonia, and have tended to increase. We should strengthen the detection of pathogenic bacteria, rationally use antibiotics, and prevent the emergence of the drugresistant strains.
出处
《实用预防医学》
CAS
2010年第1期142-144,共3页
Practical Preventive Medicine
关键词
新生儿肺炎
细菌
抗生素
耐药
Neonatal pneumonia
Bacteria
Antibiotics
Drug-tolerance
