新生儿监护室医院感染病原菌类型及药物敏感率分析

Research of Pathogenic Bacteria Types and Drug Sensitivity Rates of Neonatal Intensive Care Unit

目的:分析新生儿重症监护室医院感染病原菌类型及药物敏感率,以指导临床合理使用抗菌药物。方法:对2009年1月至2010年12月我院新生儿重症监护室(NICU)送检标本中分离的病原菌进行分析。结果:966例纳入监测患儿共送检标本981份,检测出病原菌432株,检出率为44.4%。革兰阴性杆菌占65.28%(282/432),革兰阳性球菌占34.72%(150/432)。革兰阴性杆菌主要是大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、鲍曼不动杆菌,大多数对第三和(或)四代头孢菌素、氨基糖苷类、磺胺类有较强耐药;对亚胺培南,左氧氟沙星、哌拉西林/他唑巴坦、阿米卡星、环丙沙星敏感。革兰阳性球菌主要是表皮葡萄球菌、金黄色葡萄球菌、溶血葡萄球菌,多数对青霉素类、头孢类、氨基糖苷类、大环类、氟奎诺酮类耐药,对万古霉素、奎奴普汀/达福普汀、利奈唑烷敏感。结论:重视NICU患者标本的细菌学监测,加强抗菌药物使用的宏观控制,强化医务人员以细菌培养及药敏试验结果合理使用抗菌药物,才能有效预防NICU医院感染的发生。

Objective：To analyze the pathogenic bacteria types and drug sensitivity rates of neonatal intensive care unit in order to guide rational use of antibiotic in clinic.Methods：The pathogenic bacteria from specimens of neonatal intensive care unit were analyzed statistically from Jan.2009 to Dec.2010.Results：432（44.4%） pathogenic bacterias were checked out from 981 samples.There were 282（65.28%）gram-negative bacilli and 150（34.72%） gram-positive cocci.The main gram-negative bacilli were klebsiella pneumonia,escherichia coli,enterobacter cloacae and acinetobacter Baumannii which were drug-resistant to three、fourth-generation cephalosporin,aminoglycoside,sulfonamides and sensitive to imipenem,levofloxacin,piperacillin,cefoperazone,amikacin and ciprofloxacin.The main gram-positive bacilli were coagulase negative staphylococci,staphylococcus aureus,staphylococcus haemolyticus,enterococcus faecalis which were drug-resistant to penicillins,cephalosporin,aminoglycoside,macrolides and sensitive to vancomycin,quinupristin/ dalfopristin,linezolid.Conclusion：Pay a attention to the bacteria monitoring of patients＇samples in NICU,strengthen the controlling of anti-bacteria medicine and make doctors use anti-bacteria medicine reasonably to prevent NICU hospital infection.