阴沟肠杆菌致新生儿感染17例分析

Neonatal infections induced by Enterobacter cloacae: a report of 17 cases

目的探讨阴沟肠杆菌致新生儿感染的耐药性、治疗效果及预防措施。方法对分离出的17株阴沟肠杆菌进行药敏分析并依据药敏进行治疗。结果17株阴沟肠杆菌医院内感染占70.59%,ESBLs阳性率为23.53%,对多数第三代头孢类抗生素高度耐药,对第四代头孢类抗生素敏感性达80%,对碳青霉烯类亚胺培南、美洛培南高度敏感,均为100%;经治疗后13例痊愈,4例死亡,治愈率为76.47%。结论医院内感染是新生儿期阴沟肠杆菌感染的主要途径,病死率高,临床应在合理应用抗生素的同时严格消毒灭菌,减少侵袭性操作以减少医院内感染的发生。

Objective To investigate the therapeutic effects and prevention measures for neonatal infections and the drug-resistance induced by Enterobacter cloacae. Methods A total of 17 strains of Enterobacter cloacae were isolated and the therapeutic regimen was scheduled according to drug-sensitivity test results. Results Among 17 strains of Enterobacter cloacae, 70.59 % of them were induced by nosocomial infection, 23.53 % of them were ESBLs which can produce Enterobacter cloacae. All the Enterobacter cloacae were severely resistant to majority of cephalosporins Ⅲ, and 80 % of them were susceptible to cephalosporins Ⅳ, 100 % of them were sensible to Imipenem and Meropenen. After treatment, 13 newborns healed, 4 dead, the response rate was 76.47%. Conclusion Nosocomial infection was the main vehicle of Enterobacter cloacae infection on newborns with higher mortality. Correct use of antibiotics, strict sterilization and less invasive procedures can reduce the incidence of nosocomial infection.