新生儿呼吸道感染细菌学分析

Analysis of the pathogenic bacteria causing respiratory tract infection of newborn

目的:调查2002～2004年我院新生儿病房新生儿呼吸道感染的细菌及耐药情况。方法:从新生儿病房送检的咽拭子中分离出的细菌进行鉴定和耐药率分析。结果:医院感染的201病例中,检出343株细菌,革兰氏阴性杆菌主要致病菌269株(78%),其中聚团肠杆菌感染率最高(13%)。革兰氏阳性菌中,表皮葡萄球菌感染率最高(14%)。所分离的细菌均具有多重耐药性,葡萄球菌对青霉素类抗生素耐药率很高(77%以上)。革兰氏阴性杆菌对头孢噻肟和头孢三嗪耐药率低。哌拉西林的抗菌活性较强,特别是对铜绿假单胞菌和产碱假单胞菌有较强的抗菌活性。结论:新生儿呼吸道感染的临床用药应根椐实验室报告,首选窄谱抗生素,提倡尽量应用一种抗生素,减少抗生素联合用药,严格控制预防用药。

Objective： To investigate the types of pathogenic bacteria causing respiratory tract infection of new-born infants in our hospital. Methods： Bacteria were isolated from the throat swabs of the newborn infants. The bacteria identification and susceptibility tests were performed using Automatic Microbiology Analysis Equipment-VITEK-IMS60. Results： A total of 343 strains were isolated from 201 infants suffering from respiratory tract infection, including 269 Gram-negative bacilli （78%） and 74 Gram- positive cocci （22%）. The most common Gram-negative pathogen is Enterobacter agglomerans （13%）, while Staphylococci epidermidis is the predominant Gram-positive cocci （14%）. Almost all the strains were multi-resistant to antibiotics. The resistant rate of staphylococci to penicillin is very high （77%）; The Gram-negative strains were more sensitive to cefotaxime, ceftriaxone and piperacillin. Pseudomonas aeruginosa and Pseudomonas alcaligenes are more sensitive to piperacillin. Conclusion： Antibiotics should be used according to the susceptibility test. Narrow-spectrum antibiotics should be the first choice for the infection therapy. One antibiotic is strongly suggested to used for the treatment of new-born infants infection instead of united-usage of antibiotics.