摘要
目的了解低出生体重儿败血症的病原菌分布和耐药性,为临床低出生体重儿败血症的诊断和抗菌药物的合理使用提供参考。方法对2017年1月-2018年10月入住医院新生儿重症救护中心(NICU)的低出生体重儿(LBWI)血培养阳性结果进行回顾性分析。结果共分离出病原菌726株,革兰阴性菌461株占63.50%,革兰阳性菌252株占34.71%,真菌13株占1.79%。革兰阴性菌中肺炎克雷伯菌占30.80%,产ESBLs检出率为82.39%,耐碳青霉烯肺炎克雷伯菌检出率为2.81%;大肠埃希菌占24.95%,产ESBLs检出率为60.87%。铜绿假单胞菌占9.97%,耐碳青霉稀类铜绿假单胞菌检出率为8.70%。革兰阳性菌中以凝固酶阴性葡萄球菌为主(61.11%),其次为肠球菌(11.90%)、金黄色葡萄球菌(11.11%)和B群链球菌(8.33%),耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCoNS)的检出率分别为87.66%和89.29%。另检出真菌13株,均为白假丝酵母。结论 NICU病区LBWI败血症病原菌以革兰阴性菌为主,多重耐药菌检出率高,临床应引起重视,获得早期病原学诊断、规范抗菌药物的使用,是预防和治疗LBWI感染的关键。
OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the low birth weight infants with septicemia so as to provide guidance for clinical diagnosis of septicemia and reasonable use of antibiotics.METHODS The low birth weight infants(LBWI)who were hospitalized in neonatal intensive care unit(NICU)from Jan 2017 to Oct 2018 were enrolled in the study,and the results of positive blood culture were retrospectively analyzed.RESULTS A total of 726 strains of pathogens were isolated,461(63.50%)of which were gram-negative bacteria,252(34.71%)were gram-positive bacteria,and 13(1.79%)were fungi.Among the gram-negative bacteria,Klebsiella pneumoniae accounted for 30.80%,the isolation rate of ESBLs-producing strains was 82.39%,and the isolation rate of carbapenem-resistant strains was 2.81%;Escherichia coli accounted for24.95%,the isolation rate of ESBLs-producing strains was 60.87%;Pseudomonas aeruginosa accounted for9.97%,and the isolation rate of carbapenem-resistant strains was 8.70%.Among the gram-positive bacteria,coagulase-negative Staphylococcus,Enterococcus spp,Staphylococcus aureus and group B Streptococcus accounted for 61.11%,11.90%,11.11% and 8.33%,respectively;the isolation rates of methicillin-resistant S.aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus(MRCoNS)were 87.66% and 89.29%,respectively.Totally 13 strains of fungi were isolated,all of which were Candida albicans.CONCLUSIONThe gramnegative bacteria are dominant among the pathogens isolated from the LBWI with septicemia of NICU,the isolation rate of multidrug-resistant organisms is high,and it is necessary for the hospital to attach great importance to the strains,acquire the early etiological diagnosis and reasonably use antibiotics so as to prevent and treat the infections in the LBWI.
作者
贺锐
张丽秀
谈笑
王陆军
杨晶
HE Rui;ZHANG Li-xiu;TAN Xiao;WANG Lu-jun;YANG Jing(Maternal and Child Health Hospital of Gansu Province,Lanzhou,Gansu 730050,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第6期933-936,共4页
Chinese Journal of Nosocomiology
基金
甘肃省科技厅科技支撑计划基金资助项目(1304FKCA098)
中国疾病预防控制中心合生元母婴营养与健康研究基金资助项目(2017FYH013)
关键词
低出生体重儿
败血症
病原菌
药物敏感性
Low birth weight infant
Septicemia
Pathogen
Drug susceptibility
