摘要
目的：调查新生儿重症监护病房（NICU）中早产儿铜绿假单胞菌感染的临床特点及耐药性，为其防治提供依据。方法：回顾性分析2011年9月～2013年8月广东省妇幼保健院NICU送检标本中铜绿假单胞菌培养阳性的早产患儿的临床资料。结果：早产儿铜绿假单胞菌感染的主要临床表现为呼吸困难、反应差、皮肤苍白、经皮血氧饱和度下降、气促、血糖不稳定、腹胀和发热等。实验室检查提示白细胞、CRP升高，血小板降低为较敏感的指标。铜绿假单胞菌对头孢唑啉、头孢呋辛、氨苄西林和氨苄西林／舒巴坦100％耐药，对哌拉西林、哌拉西林／舒巴坦、头孢他啶和头孢吡肟的敏感性较高。经合理治疗，53例铜绿假单胞菌感染患儿中治疗后好转或治愈出院48例，死亡5例。结论：早产儿铜绿假单胞菌感染临床表现多样，对存在严重基础疾病，机械辅助通气及住院时间长的患者应警惕铜绿假单胞菌感染，选用合适的抗菌药物治疗改善预后。
Objective:To investigate the clinical characteristics and drug resistance of Pseudomonas aeruginosa infection in premature infants in neonatal intensive care unit(NICU),provide a basis for prevention and treatment of Pseudomonas aeruginosa infection.Methods:The clinical data of premature infants in NICU with positive Pseudomonas aeruginosa from September 2011 to August 2013 were analyzed retrospectively.Results:The main clinical manifestations of Pseudomonas aeruginosa in premature infants included respiratory difficulties,poor response,pale skin,decreased oxygen saturation,dyspnea,unstable blood sugar,distending abdomen,fever and so on.Laboratory examinations indicated that the more sensitive indicators included elevated white blood cells and CRP,reduced platelets.The drug resistance rates of Pseudomonas aeruginosa to ceftazidime,cefuroxime,ampicillin and ampicillin / sulbactam were 100%,the sensitivities of Pseudomonas aeruginosa to piperacillin,piperacillin / sulbactam,ceftazidime and cefepime were relatively high.After reasonable treatment,among 53 premature infants,48 preterm infants were recovered or improved,5 children died.Conclusion:The clinical manifestations of Pseudomonas aeruginosa infection in preterm infants vary.Pseudomonas aeruginosa infection should be alert in preterm infants with serious underlying diseases,assisted mechanical ventilation and hospitalization for a long time,appropriate antimicrobial therapy can improve the prognosis.
出处
《中国妇幼保健》
CAS
北大核心
2014年第14期2160-2162,共3页
Maternal and Child Health Care of China
基金
广东省科技计划项目〔2010B060900057〕
关键词
新生儿重症监护病房
铜绿假单胞菌
临床特点
Neonatal intensive care unit
Pseudomonas aeruginosa
Clinical characteristics
