摘要
目的 分析近3年李斯特菌感染临床分布及耐药性变迁情况，提高对本病的认识，为临床合理用药提供参考依据。方法 对2011年1月至2013年12月北京军区总医院附属八一儿童医院收治的22例新生儿李斯特菌感染临床特征及耐药性变迁进行回顾性分析。结果 患儿出生后 0.5 h～5 d发病（平均17.45 h）；出生体质量（2 331.82 ±677.64）g；足月儿7例，早产儿15例；低出生体质量儿 13例。住院时间（21.91±17.64）d，治愈率为45.45%（10/22例）。产妇孕晚期出现发热15例，体温37.5～39.5 ℃ 。李斯特菌3年感染率分别为0.03%（2/7137例）、0.11%（8/7281例）、0.19%（12/6394例）。2011年至2013年李斯特菌对常用抗菌药物敏感率分别为82.72% 、75.40% 、50.66% ；耐药率分别为17.28% 、17.50% 、11.01% ，3年中耐药率变化差异无统计学意义（χ^23.65，P 〉0.05），敏感率呈逐年下降趋势（χ^236.87，P 〈0.01）。李斯特菌对青霉素类药物敏感率为 33.93%（19/56例），耐药率为 51.79%（29/56例），各年间其耐药率分别为100.00% 、40.00% 、46.43% ，敏感率为0、60.00% 、25.00% 。李斯特菌对氨苄西林、氨基糖苷类、糖肽类、四环素类、大环内酯类、林可胺类、喹诺酮类、磺胺类、其他（如利福平等）等抗菌药物具有较好的敏感性，对苯唑西林、青霉素和硝基呋喃类耐药率为33.33% ～100.00% 。结论 本组患儿具有早发型感染的特点，孕妇和新生儿是易感的高危人群，感染率及临床分离菌株呈逐年增多趋势，李斯特菌对常用抗菌药物具有较好的敏感性，对青霉素类药物耐药性有一定程度下降，但仍处于较高水平。对苯唑西林、青霉素G和硝基呋喃类药物耐药。
Objective To study the clinical distribution of Listeria monocytogenes infection and the changes in drug resistance of Listeria monocytogenes isolated from inpatients during recent 3 years, and to increase the awareness of the situation and provide data for clinical antibiotics application. Methods The clinical distribution of 22 cases of neo- natal Listeria infection and drug resistance changes of Listeria were retrospectively analyzed in Bayi Children＇s Hospital from Jan. 2011 to Dec. 2013. Results Neonates began to be attacked by Listeria monocytogenes of 0.5 hours to 5 days （ an average of 17.45 hours） after birth. The average birth weight was （2 331.82 ± 677.64） g. There were 7 full term cases and 15 premature infants, 13 cases with low birth weight. The average hospitalization was （21.91 ± 17.64） days. The cure rate was 45.45% （ 10/22 cases）. All the mothers of 15 cases had fever in the third trimester of pregnancy and the temperature was 37.5 -39.5 ℃. Infection rate with Listeria monocytogenes in neonatal was 0.03% （2/7 137 cases） ,0.11% （8/7 281 cases） and 0.19% （ 12/6 394 cases） in 3 years,respectively. From 2011 to 2013,the sensitive rate of antimicrobial drugs with Listeria monocytogenes to commonly used antimicrobial was 82.72% ,75.40% and 50.66% , and the rate of drug resistance was 17.28% , 17.50% and 11.01% , respectively. During 3 years,the rates of drug resistance had no significant difference （χ^2 = 3.65, P 〉 0.05 ） , and the sensitive rates had a trend of declination year by year（χ^2 = 36.87, P 〈 0.01 ）. The sensitive rates and the drugs resistant rates of penicillin were 33.93% （ 19/56 cases）and 51.79% （29/56 cases）, respectively. In 3 years, the drugs resistant rates of penicillin was 100.00% , 40.00% ,and 46.43% ,and the sensitive rate was 0,60.00% , 25.00% , respectively. There was a high sensitivity of Listeria monocytogenes to ampicillin, aminoglycoside, sugar peptide, tetracycline, macrolides, lincosamides, quinolone, sulfa and othe
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第22期1692-1695,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
国家自然科学基金（31100603）
关键词
婴儿
新生
李斯特菌
感染
脓毒症
耐药性变迁
Infant, newborn
Listeria monocytogenes
Infection
Sepsis
Change in drug resistance
