摘要
目的:分析河南省112所医院2020–2022年新生儿病原菌的分布及耐药性,为新生儿抗菌药物的临床合理应用提供依据。方法:收集河南省细菌耐药监测网中有关新生儿病原菌分布及耐药性检测的资料数据,采用WHONET 2020进行数据分析。结果:2020–2022年共检出病原菌总数为3221株,其中革兰阴性菌(G^(-))1935株(60.1%),革兰阳性菌(G^(+))1286株(39.9%)。G^(-)检出前3位是肺炎克雷伯菌610株(18.9%),大肠埃希菌415株(12.9%),鲍曼不动杆菌184株(5.7%);G^(+)检出前3位是金黄色葡萄球菌549株(17.0%),表皮葡萄球菌235株(7.3%),屎肠球菌170株(5.3%)。2020–2022年河南省新生儿感染的病原菌的构成比较稳定,以G^(-)为主,肺炎克雷伯菌对头孢噻肟等多种抗菌药物呈现较高的耐药性,大肠埃希菌对氨苄西林的耐药率在2020年及2021年均超过80%,鲍曼不动杆菌对阿莫西林/克拉维酸的耐药率在2020年达到了67.3%。G^(+)中,2020–2022年,金黄色葡萄球菌和凝固酶阴性葡萄球菌对青霉素G的耐药率均高于90%,未检测出耐万古霉素的金黄色葡萄球菌和凝固酶阴性葡萄球菌。结论:河南省新生儿患者的病原菌主要是G^(-),个别病原菌耐药情况较严重,临床医师应及时了解区域内病原菌的流行趋势,根据药敏检测的结果选择合适的抗菌药,医院应加强常见病原菌的耐药监测和防控,保障医疗安全。
Objective To analyze the distribution and drug resistance of pathogens isolated from neonates in 112 hospitals in Henan Province from 2020 to 2022,and to provide a basis for the rational use of antibiotics in neonates.Methods The data of the distribution and drug resistance of pathogenic bacteria in neonates were collected from the bacterial resistance surveillance network of Henan Province,and WHONET 2020 was used for data analysis.Results A total of 3,221 strains of pathogens were detected from 2020 to 2022,including 1935 strains(60.1%)of Gram-negative bacteria(G^(-))and 1286 strains(39.9%)of Gram-positive bacteria(G^(+)).The top three G^(-)strains were 610 strains of Klebsiella pneumoniae(18.9%),415 strains of Escherichia coli(12.9%),and 184 strains of Acinetobacter baumannii(5.7%).The top three G^(+)strains were 549 strains of Staphylococcus aureus(17.0%),235 strains of Staphylococcus epidermidis(7.3%),and 170 strains of Enterococcus faecium(5.3%).From 2020 to 2022,the composition of pathogenic bacteria in neonatal infections in Henan Province remained relatively stable,mainly G^(-).Klebsiella pneumoniae displayed high resistance to various antibacterial drugs such as cefotaxime.The resistance rate of Escherichia coli to ampicillin exceeded 80%in 2020 and 2021,and the resistance rate of Acinetobacter baumannii to amoxicillin/clavulanic acid reached 67.3%in 2020.Among the G^(+)strains,the resistance rates of Staphylococcus aureus and coagulase negative Staphylococcus to penicillin G were higher than 90%from 2020 to 2022,and no vancomycin-resistant Staphylococcus aureus or coagulase negative Staphylococcus was detected.Conclusion The main pathogens of neonatal patients in Henan Province are G^(-),and the drug resistance of some pathogens is serious.Clinicians should timely understand the epidemiological trends of pathogenic bacteria in the region,and select appropriate antibacterial drugs according to the results of drug sensitivity testing.
作者
张瑞
赵向德
刘克锋
ZHANG Rui;ZHAO Xiangde;LIU Kefeng(The First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450000;Zhengzhou Maternal and Child Health Hospital,Henan Zhengzhou 450012)
出处
《深圳中西医结合杂志》
2023年第16期12-15,F0003,共5页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
院内感染
病原菌
耐药性
新生儿
Nosocomial infection
Pathogenic bacteria
Drug resistance
Newborn baby
