新生儿感染性肺炎病原菌及其耐药性分析

Pathogenic Bacteria of Infectious Pneumonia and Their Antimicrobial Resistance in Newborn

目的了解新生儿感染性肺炎患儿病原菌及其药敏变迁情况。方法对2005—2008年首都医科大学大兴医院新生儿病房感染性肺炎住院患儿痰培养阳性标本结果进行回顾性分析。结果 (1)300份痰培养标本分离出细菌187株,其中革兰阴性杆菌152株(占81.3%),病原菌主要为大肠埃希菌、肺炎克雷伯杆菌、铜绿假单胞菌和阴沟肠杆菌;革兰阳性球菌35株(占18.7%),主要病原菌为金黄色葡萄球菌、表皮葡萄球菌和链球菌。(2)不同年份病原菌的构成比比较,差异无统计学意义(P>0.05)。(3)药敏试验结果4年间主要革兰阴性杆菌对大多数常用抗菌药耐药率无明显变化,差异无统计学意义(P>0.05)。仅对亚胺培南的耐药率增加了,2008年与2005年比较差异有统计学意义(P<0.05)。对亚胺培南、头孢哌酮/舒巴坦的耐药率分别为0～10.5%、4.0%～10.5%。未发现耐万古霉素的革兰阳性球菌。结论新生儿感染性肺炎病原菌以革兰阴性杆菌为主,不同年份病原菌的构成比变化不明显。主要病原菌对大多数抗菌药物的耐药率变化不大,临床应合理使用抗菌药,以延缓细菌耐药性的产生。

Objective To study the conditions of pathogenic bacteria and their antimicrobial resistance in newborns with infectious pneumonia.Methods Retrospective analysis was conducted for the results of sputum culture positive samples of newborn inpatients in Danxing hospital of the capital university of medical science from 200 to 2008.Results Totally 187 strains were isolated from 300 sputum culture samples,of which there were 152 strains of Gram-negative bacilli （81.3%）,including E Coli,Klebsiella pneumonia,Pseudomonasaeruginosa and Enteric cloacae;and 35 strains of Gram-positive cocci （18.7%）,including Staphylococcus aureus,coagulase-negative Staphylococcus and Streptococcus.The component ratios of the pathogenic bacteria in different years showed no statistic difference （P0.05）.The antimicrobial susceptibility tests showed there was no significant difference in drug resistance rate of common Gram-negative bacilli to the commonly used antibiotics during the four years （P0.05）,only the rate to Imipenem increased,and with a statistic difference as compared the rate in 2005 with that in 2008 （P0.05）.The rates of strains of gram-negative bacilli to Imipenem and cebfoperazone-sulbactam were 0~10.5% and 4.0~10.5% respectively.All gram-positive cocci were susceptible to vancomycin.ConclusionGram-negative bacilli are the leading pathogens to newborn infectious pneumonia.The change of component ratios in different years is not obvious.Antibiotic resistance rates of main pathogenic bacteria to most antimicrobials have no evident change.Rational use of antibiotics is important for the containment of bacterial resistance.