新生儿败血症病原学与耐药性特征

An analysis of pathogens and drug sensitivity of neonatal septicemia

目的探讨新生儿败血症病原学特点和分析致病菌耐药情况。方法分析无锡人民医院新生儿科285例新生儿败血症患儿培养检出菌及药敏实验结果情况。结果临床诊断败血症的血液标本中检出病原菌285株,其中G+245株(86.0%),G-40株(14.0%)。排在前五位的菌种是表皮葡萄球菌87株(30.5%)、溶血葡萄球菌49株(17.2%)、模仿葡萄球菌24株(8.4%)、金黄色葡萄球菌21株(7.4%)、大肠埃希菌18株(6.3%)。G+对青霉素G(90.0%)、苯唑西林(74.7%)、红霉素(74.3%)及氨苄西林(71.4%)耐药性高,对万古霉素、呋喃妥因未产生耐药(0.0%)。G-对氨苄西林(72.5%)耐药性高,对头孢哌酮/舒巴坦、亚胺培南及美罗培南未产生耐药(0.0%)。结论重视新生儿败血症病原菌耐药性检测,根据药敏结果选用敏感抗菌药物,可减少细菌耐药性的产生,提高临床治疗效果。

Objective To explore pathogens characteristics isolated from neonates with septicemia and analyze their drug sensitivity.Methods The results of blood culture and drug susceptibility test for 285 neonatal patients with septicemia treated in our hospital were analyzed.Results Out of the blood samples,285 stains were detected with a result of Gram positive（245strains） accounting for 86.0% and Gram negative（40 strains） accounting for 14.0%.87 strains Staphylococcus epidermidis 30.5%,49 strains Staphylococcus haemolyticus 17.2%,24 strains Staphylococcus simulans 8.4%,21 strains Staphylococcus aureus 7.4%,18 strains Escherichia coli 6.3 % were the five most common pathogens.Gram positive cocci demonstrated a strong resistance to penicillin（90.0%）,oxacillin（74.7%）,erythromycin（74.3%） and ampicillin（71.4%）,and was susceptible to vancomycin and nitrofurantoin.The resistance of Gram negative bacilli to ampicillin（72.5%）was high,and their susceptibility to cefoperazone/ sulbactam,imipenem and meropenem was evident.Conclusions Much more attention should be paid to drug resistance detection in the treatment of neonatal septicemia.Choosing sensitive antibiotics based on the drug sensitivity tests may decrease the occurrence of drug resistant bacteria and increase the clinical curative effects.