新生儿重症监护病房下呼吸道感染细菌及耐药性分析

Clinical investigation on bacterial drug resistance of lower respiratory tract nosocomial infection in neonatal intensive care unit

目的探讨新生儿重症监护病房(NICU)患儿院内感染的病原菌分布特点及耐药情况,为临床合理使用抗菌素提供依据。方法对医院NICU送检标本所分离的87株病原菌的分布及耐药情况进行回顾性分析。结果87株分离病原菌中,G-杆菌占68.97%(60/87),G+球菌占26.44%(23/87),真菌占4.60%(4/87)。G-杆菌以肺炎克雷伯菌33.33%(29/87)、鲍曼不动杆菌13.79%(12/87)、大肠埃希氏菌6.90%(6/87)、铜绿假单胞菌5.74%(5/87)为主,G+球菌以表皮葡萄球菌8.05%(8/87)、链球菌6.90%(6/87)、金黄色葡萄球菌3.44%(3/87)、粪肠球菌2.29%(2/87)为主,真菌均为白色念珠菌。分离菌株对第三代头孢类药和青霉素类药耐药率较高。结论G-杆菌为新生儿重症监护病房感染常见的病原菌。分离菌株对头孢第三代类药物耐药率高。加强耐药监测,合理使用抗生素对有效控制NICU感染十分重要。

Objective To investigate the distribution of pathogens and their antibiotic resistance of hospital infection in neonatal intensive care unit, and instruct clinical application of antibiotics reasonably. Methods Retrospective analysis was made on the distribution of bacteria and drug resistance situation of NICU in our hospital. Results Eighty seven pathogens were identified from NICU. Of all cases, 68.97% were Gram-negative, 26.44% were Gram-positive, and 4.60% were epiphyte. The most common gram-negative bacilli in low respiratory tract were Klebsiella pneumonia（33.33%）, Acinetobacter bau-Mannii（13.79%）, Escherichia coli（6.90%） and pseu- domonas aeruginosa （5.74%）. The common gram-positive cocci were S.epidermidis （8.05%）, Streptococcus （6.90%）, S.aureus（3.44%） and E. faecalis（2.29%）. All the bacteria showed multidrug resistance. Conclusion Gram-negative bacilli are the major pathogenic bacteria and they are strongly resistant to the third generation cephalosporins. Drug resistance monitoring and reasonable application of the antibiotics are important to control infection effectively.