武汉地区住院新生儿主要分离菌构成及耐药性分析

Distribution and Anti-microbial Resistance of Pathogenic Bacteria Isolated from Hospitalized Neonates in Wuhan Area

目的分析武汉地区住院新生儿病原菌的分布情况及耐药性。方法对2006-2007年武汉地区住院新生儿临床送检标本进行培养，采用VITEK32全自动细菌分析系统鉴定分离菌，K—B纸片扩散法进行药敏试验，以NCCLS2006年版标准判读结果。结果从10053份送检标本中检出病原菌3892株，阳性率为38．7％；其中革兰阳性球菌1597株（41．0％），革兰阴性杆菌2148株（55．2％）；MRCNS占凝固酶阴性葡萄球菌的68．6％，而MRSA占金黄色葡萄球菌比例较低（2．6％）；肠球菌属在新生儿的血液感染比以往升高;大肠埃希菌和肺炎克雷伯菌ESBLs阳性率分别为46．9％、34．7％。结论武汉地区住院新生儿病原菌构成和耐药状况有地域性和群体性特点；迫切需要加强对新生儿感染细菌区域性流行特点及耐药状况进行定期监测。

OBJECTIVE To analyze the distribution and anti-microbial resistance profile of pathogenic bacteria isolated from hospitalized neonates in Wuhan area. METHODS The strains of bacteria isolated from neonates in hospitalization of Wuhan area from 2006 to 2007 were identified by VITEK 32 automatic bacteria system and antimicrobial susceptibility test was pergormed by Kirby-Bauer method. The standards of NCCLS issued in 2006 were used to assess the results of antimicrobial susceptibility. RESULTS A total of 3892 strains of bacteria were isolated from 10053 specimens, the positive rate was 38. 7%. The Gram-positive cocci and Gram-negative bacilli accounted for 41.0% and 55.2%, respectively. The leading 8 species on the list of isolated strains in the two years accounted for 90. 8% of all the isolated strains. MRCNS accounted for 68. 6% of coagulase negative staphylococcus, and the MRSA kept a low rate （2.6%） in Staphylococcus aureus. The infection rate of newborn by Enterococcus in blood was remarkably higher than that of the past report in this area. The β- lactamases-producing Escherichia coli and Klebsiella pneurnoniae were accounted for 46. 9% and 34. 7%, respectively. CONCLUSIONS The distribution and anti-microbial resistance of hospitalized neonates in Wuhan area have regional and group characteristics; it＇s necessary to strengthen monitoring the regional epidemic characteristic status and the drug-resistant status of the pathogenic bacteria among neonates.