摘要
目的了解新生儿败血症病原学及细菌耐药状况,为临床合理用药提供依据。方法收集本院2014年1月-2016年6月血培养阳性的败血症病例258例,对其分离的菌株进行鉴定和体外药敏分析。结果 258例血培养阳性标本中,检出革兰阳性菌152例(占58.91%),其中以凝固酶阴性葡萄球菌(CNS)为主;革兰阴性菌85例(占32.95%),其中以大肠埃希菌和肺炎克雷伯菌为主;真菌21例(占8.14%),其中以白念珠菌为主。革兰阳性菌中检出的凝固酶阴性葡萄球菌、金黄色葡萄球菌对青霉素、苯唑西林、大环内酯类耐药率大于等于75%,对万古霉素、利奈唑胺、替考拉宁均敏感。革兰阴性菌中大肠埃希菌、肺炎克雷伯菌对氨苄西林普遍耐药,对头孢菌素类抗生素耐药率高于30%,对氨基糖甙类、喹诺酮类及碳青霉烯类抗生素有较高的敏感性;白念珠菌对氟康唑的耐药率为8.33%,光滑念珠菌对氟康唑普遍耐药。结论 CNS、大肠埃希菌和肺炎克雷伯菌为新生儿败血症的常见病原菌,且对常见抗生素耐药率较高,临床医师应合理应用抗生素,以提高临床治疗效果。
Objective To investigate distribution characteristics and antibiotic resistance of pathogens in neonatal septicemia provides the basis for clinical treatment. Methods The 258 cases of blood culture and drug susceptibility test for neonates diagnosed with septicemia from Jan 2014 to June 2016 were retrospectively analyzed, and the isolated strains were identified and their resistance to antibiotics were tested. Result A total of 258 strains were detected in culture-positive blood samples, with a result of 152 Gram-positive strains （58.91%）,85Gram-negative strains （32.95%）,and 21 strains of fungi （8.14%）. The most common pathogens of Gram-negative strains, Gram-positive strains and fungi were Coagulase-negative Staphylococcus, Escherichia coli and Klebsiella pneumonia,and Candida albicans,respectively. Coagulase-negative Staphylococcus and Staphylococcus aureus demon- strated strong resistance to penicillin, oxacillin and macrolides was greater than or equal to 75%,while they were sensitive to van- comycin, linezolid and teicoplanin completely. The resistance rate of Gram-negative Escherichia coli and Klebsiella pneumonia to ampicillin and cephalosporins were respectively 100% and more than 30% ,and their susceptibility to aminoglycosides,quinolones and carbapenems was evident. Candida albicans bore a low resistance to fluconazole （8.33%）. Conclusion Coagulase-negative staphylococci, Escherichia coli and Klebsiella pneumonia were common pathogens causing neonatal septicemia in our hospital, and their resistance to common antibiotics condition were high and serious. It is reminded that the clinical use of antibiotics should be reasonably used to improve clinical efficacy.
作者
泰淑红
王鹏
邵艳
贾莉婷
TAI Shuhong WANGPeng SHAO Yan JIA Liting.(Department of Laboratory Medicine ,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, Chin)
出处
《实验与检验医学》
CAS
2017年第4期461-463,共3页
Experimental and Laboratory Medicine
基金
河南省科技厅重点科研团队项目资助(编号:B20140269)
关键词
新生儿
败血症
耐药性
病原菌
Neonate
Septicemia
Pathogen
Antibiotic resistance
