新生儿病房病原菌构成及其耐药性分析

Composition and drug resistance analysis of pathogens in neonatal ward

目的了解2009-2010年新生儿病房医院感染病原菌的阳性率、构成特点及其耐药性变化,为临床合理使用抗菌药物提供依据,并为加强控制医院感染的发生提供实验室诊断依据。方法对新生儿病房2009年7月-2010年7月所分离出的病原菌及其耐药性进行回顾性调查分析。结果所有送检标本共752份,检出病原菌72株,检出率9.6%;在所有分离菌中,以血培养标本检出率最高,为59.7%,痰和咽拭子次之,为29.2%;前4位病原菌依次为凝固酶阴性葡萄球菌、大肠埃希菌、酿脓链球菌和嗜血菌属,分别占44.5%、16.7%、5.5%及5.5%;葡萄球菌属和革兰阴性杆菌对常用抗菌药物耐药严重,且呈多药耐药,耐甲氧西林葡萄球菌(MRS)检出率为70.6%,产ESBLs革兰阴性杆菌检出率为35.0%。结论进行病原学监测,了解病原菌构成、分布及其耐药趋势,对合理选择抗菌药物、降低新生儿感染发生率和死亡率、减少耐药菌株产生和控制医院感染暴发及流行均有重要价值。

OBJECTIVE To investigate the positive rate and clinical composing characteristics and drug resistances of pathogens in neonatal ward from 2009 to 2010,for instructing clinical application of antibiotics reasonably and controlling the occurrence of nosocomial infection.METHODS A retrospective investigation analysis was made for all the isolated bacteria as well as their drug resistances in neonatal ward from Jul 2009 to Jul 2010.RESULTS The results showed that 72 strains of pathogens were isolated from 752 detected samples with the detection rate of 9.6%.Coagulase negative Staphylococcus,Escherichia coli,Streptococcus pyogenes and Haemophilus spp were the most frequently isolated pathogens.In all the isolated bacteria,the blood culture specimens occupied the highest proportion（59.7%）,the sputum and throat specimens were second（29.2%）.Staphylococcus spp and G-bacilli were highly resistant to commonly used antibiotics and demonstrated multi-drug resistance.The methicillin-resistant Staphylococcus（MRS） was 70.6%.The detection rate of ESBLs-producing G-bacilli was 35.0%.CONCLUSION Inspecting pathogens and studying the composition of pathogens and the trend of their drug resistance are important to rationally select antibiotics,reduceing infection incidence and mortality rate,decreasing the occurrence of drug resistant strains in neonates and controling the outbreak and prevalence of nosocomial infection.