摘要
目的:探讨新生儿重症监护病房(NICU)呼吸道感染常见病原菌的分布及耐药情况,为临床合理选用抗菌药物提供参考。方法:对本院2009年1月至2010年12月NICU患儿送检呼吸道标本所分离病原菌的分布及药敏结果进行统计分析。结果:共检出病原菌367株,分离率前6位的病原菌依次为肺炎克雷伯菌(46.0%)、大肠埃希菌(13.9%)、铜绿假单胞菌(10.9%)、阴沟肠杆菌(8.7%)、金黄色葡萄球菌(5.7%)、真菌(4.9%)。耐药性分析显示,肺炎克雷伯菌耐药情况严重,ESBLs产生率54.4%,对头孢噻肟、头孢曲松的耐药率分别达91.7%、90.5%,对头孢吡肟、头孢哌酮/舒巴坦、阿莫西林/克拉维酸、头孢他啶、庆大霉素的耐药率分别为68.6%、66.9%、66.9%、47.3%、44.4%,对环丙沙星和阿米卡星的耐药率较低,分别为7.7%和16.6%。大肠埃希菌对青霉素、头孢菌素类的耐药率较高,对亚胺培南、环丙沙星和阿米卡星敏感或较为敏感,ESBLs产生率51.0%,未检出对亚胺培南耐药的肠杆菌科细菌。铜绿假单胞菌除对阿莫西林/克拉维酸、头孢曲松和头孢噻肟的耐药率较高外,对其余抗生素较为敏感或高度敏感。金黄色葡萄球菌对青霉素、红霉素耐药率较高,分别为95.2%、71.4%,对克林霉素、头孢他啶、头孢西丁、阿莫西林/棒酸的耐药率则较低,分别为23.8%、23.8%、14.3%、4.7%,检出MARSA 3株(14.3%),未发现万古霉素耐药的菌株;检出4株肺炎链球菌全部对红霉素的耐药,对β-内酰胺类药物耐药性不严重。结论:肺炎克雷伯菌为NICU患儿呼吸道感染的主要病原菌,且对常用抗生素耐药情况严重。根据病原菌种类及药敏结果合理应用抗菌药是有效控制危重病患儿感染和减少耐药菌株产生的重要手段。
ABSTRACT Objective： To investigate the distribution of common pathogenic bacterium and drug resistance of respiratory tract infections in neonatal intensive care unit （NICU）, and provide references for rational use of antibiotics in clinic. Methods： Distribution and drug susceptibility of the pathogenic bacteria from respiratory tract specimens were statistically analyzed from January 2009 to December 2010 in NICU. Results： There were 367 strains of pathogens, of which the first 6 isolation rate of pathogenic bacteria were Klebsiella pneumoniae （46%）, Escherichia colt （13.9%）, Pseudomonas aeruginosa （10.9%）, Enterobacter cloacae （8.7%）, Staphylococcus aureus （5.7%）, fungi （4.9%）. Analysis of drug resistance, Klebsiella pneumoniae resistance in severe cases, ESBLs production rate 54.4%, the resistance rate of cefotaxime, ceftriaxone is respectively 91.7%, 90.5%, the resistance rate of cefepime, Cefoperazone/sulbactam, amoxicillin/clavulanic acid, ceftazidime, gentamicin is respectively 68.6%, 66.9%, 66.9%, 47.3%, 44.4%, low resistance rate of ciprofloxacin and Amikacin, respectively 7.7% and 16.6 %. Escherichia colt high rates of resistance to penicillin, cephalosporins, sensitive or more sensitive to imipenem, ciprofloxacin, amikacin, ESBLs generation rate 51%. Imipenem resistance in Enterobacteriaceae bacteria of which the first 6 found. Pseudomonas aeruginosa in addition to amoxicillin/elavulanic acid, ceflriaxone, cefotaxime resistance rate is higher, more sensitive or highly sensitive to other antibiotics. Drug resistance of Staphylococcus aureus to penicillin, erythromycin is higher, respectively 95.2%, 71.4%, low resistance rate of clindamycin, ceftazidime, cefoxitin, amoxicillin/clavulanic acid, respectively 23.8%, 23.8%, 14.3%, 4.7%, MARSA is detected in 3 strains （14.3%）, vancomycin resistant strains not found; Streptococcus pneumoniae among 4 strains resistant to all erythromycin, resistance to β-1actam drugs is not serious. Conclusions＇ Klebsiella pneumoniae was
出处
《现代生物医学进展》
CAS
2012年第29期5675-5678,共4页
Progress in Modern Biomedicine
基金
国家自然科学基金(30801054)
