新生儿肺炎病原菌的临床分析

Clinical analysis on pathogens in neonatal pneumonia

目的探讨新生儿肺炎主要致病菌及药物敏感性。方法选取2008年1月至2011年5月我科住院的新生儿肺炎患者395例,对其痰液进行细菌培养并行药物敏感试验。结果本组395例标本共培养出阳性致病菌151株,阳性率38.22%,其中大肠埃希菌23株(7.08%),鲍曼不动杆菌16株(4.92%),土生克雷伯菌41株(12.62%),肺炎克雷伯菌35株(10.77%),阴沟肠杆菌28株(8.62%),其他8株(2.46%)。肺炎克雷伯菌对亚胺培南、氨基糖甙类、喹诺酮类较敏感,对哌拉西林他唑巴坦耐药;大肠埃希菌、克雷伯菌、鲍曼不动杆菌对亚胺培南、环丙沙星、复方β-内酰胺类较敏感。结论大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、土生克雷伯菌是新生儿肺炎的常见病原菌,痰培养是目前新生儿肺炎重要的病原监测手段之一。

Objective To investigate the main pathogenic bacteria and the drug sensitivity of neonatal pneumonia.Methods 395 neonates with pneumonia were selected from January 2008 to May 2010 and their sputum specimens were cultivated,then tested by drug sensitivity.Results In 395 specimens,positive pathogenic bacteria were cultivated out in 151 cases,with the positive rate of 46.46%.Among them,23 strains（7.08%） were Escherichia coli,16 strains（4.92%） were Baumanii,41strains（12.62%） were Klebsiella terrigena,35 strains（10.77%） were Klebsiella pneumoniae,28 strains（8.62%） were Enterobacter cloacae,8 strains（2.46%） were other bacteria.And Klebsiella pneumonia was sensitive to imipenem,aminoglycosides and quinolonos,however,resistant to piperacillin and tazobactam.Escherichia coli,klebsiella terrigena and Baumanii were sensitive to imipenem,ciprofloxacin and compound β lactams.Conclusion Escherichia coli,Klebsiella pneumonia,Klebsiella terrigena and Enterobacter cloacae were the common pathogens of neonatal pneumonia.Sputum culture is one of important surveillance measures to neonate pneumonia.