广东地区新生儿败血症血培养结果分析

Analysis of positive culture results of pathogens from neonatal septicemia cases in Guangdong Province

目的了解广东地区新生儿败血症的病原学及耐药性现状。方法应用全自动血培养系统(Bact/ALERT3D120)对2007年5月～2009年4月广东省妇幼保健院收治并确诊的105例新生儿败血症患儿的血液进行培养,并以全自动细菌鉴定分析系统(VITEK-2compact)对分离的菌株进行鉴定和药敏试验。结果革兰氏阳性球菌为主要病原菌,其次为革兰氏阴性杆菌,排名前三位的病原菌分别是表皮葡萄球菌(28.6%),肺炎克雷伯菌肺炎亚种(17.1%),大肠埃希菌(14.3%);细菌的产酶率较高,对多种抗生素耐药,对培养出的革兰氏阳性球菌最敏感的抗生素是奎诺普汀/达福普汀、利奈唑烷、和万古霉素,对培养出的革兰氏阴性杆菌最敏感的抗生素是丁胺卡那霉素和头孢替坦。结论广东地区近年新生儿败血症病原菌的耐药菌株明显增多,条件致病菌大大增加,根据药敏结果合理地选择抗生素对病例治疗和减少细菌耐药性的产生具有重要意义。

Objective To survey the pathogenic bacteria and their drug resistance in neonatal septicemia cases in Guangdong for rational use of antibiotics in clinical treatment. Methods There 105 blood samples of neonatal septicemia cases from May 2007 to April 2009 in our hospital were cultured by Bact/ALE-RT3D120 automated blood culture system, the isolated strains were identified and their resistance to antibiotics was tested by VITEK-2 automicroscan. Results gram-positive cocci were the main pathogens, followed by gram-negative bacilli. The predominated strain was Staphylococcus epidermidis （28.6%）,followed by Klebsiella pneumonia （17.1%）, and the third is E. coli（14.3%）. Gram-positive cocci was most sensitive to daifo-pristin,Zyvox and vancocin,while gram-negative bacilli was sensitive to amikacin and cefotetan. Conclusion There are increasing quantity of drug-resistant pathogens from blood samples of neonatal septicemia cases. Thus drug sensitivity test be carried for sake of rational use of anbiotics.