98例新生儿败血症病原菌及耐药性分析

Pathogens and Antibiotic Resistance Analysis of 98 cases of Neonatal Septicemia

目的探讨我院新生儿败血症的病原菌分布及耐药性，指导临床合理使用抗生素。方法对我院2004年12月-2008年3月新生儿血培养阳性标本细菌鉴定及药敏结果进行分析总结。结果98例101次血培养阳性标本中，革兰阳性球菌95例占94．1％，革兰阴性菌6例占5．9％；革兰阳性球菌中松鼠葡萄球菌35例占34．7％，表皮葡萄球菌23例占22．8％，模仿葡萄球菌21例占20．8％，均对多种抗生素耐药，对青霉素全部耐药，对氨苄西林／舒巴坦、红霉素耐药率70％以上，对万古霉素100％敏感；分离的革兰阴性菌有大肠埃希菌2例、阴沟肠杆菌1例、坂崎肠杆菌1例、干燥棒状杆菌1例、铜绿假单胞菌1例，抗菌活性较好的药物是亚安培南、第三代头孢、哌拉西林／他唑巴坦等。结论葡萄球菌是新生儿败血症的主要病原菌，对常用抗菌药物有不同程度的耐药。全面了解和掌握细菌种类开口耐药性变化对临床合理选用抗生素具有重要意义。

Objective To investigate the distribution and antibiotic resistance of neonatal septicemia pathogens in our hospital and guiding the rational use of antibiotics. Methods The strain identification and susceptibility results were analyzed and summarized of the neonatal blood culture positive bacterial from December 2004 to March 2008. Results In 98 patients with 101 cases positive blood culture samples, 95 cases Gram-positive cocci account for 94.1%, 6 cases Gram-negative bacteria hold 5.9% in Gram-positive cocci squirrels; In all Gram-positive Cocci, 35 cases Staphylococcus account for 34.7% , 23 cases Staphylococcus epidermidis accounted for 22.8%, 21 cases imitation Staphylococcus aureus, 20.8% were resistant to multiple antibiotics. All resistance to penicillin, more than 70% resistance to ampicillin/sulbactam, erythromycin. Vancomycin mycophenolate is i00% sensitive. Of the separating Gram-negative bacteria ,Escherichia coli is 2 cases, Enterobacter cloacae is l case Enterobacter of Kawasaki Sakamoto is l case, dry Corynebacterium is l cases, of Pseudomonas aeruginosa is i case. Good antibacterial activity Eanpeina drug is Imipenem ,the third generation cephalosporins and piperacillin/tazobactam, etc. Conclusion Staphylococcus aureus is a major pathogen neonatal sepsis, it has varying degrees of resistance to the common antibacterials. It is great significance for comprehension and grasp of the bacteria types and drug tolerance and reasonable selecting antibiotics.