新生儿感染性肺炎的病原菌状况分析

Investigation of pathogenic bacteria and antibiotic susceptibility in neonatal infective pneumonia

目的了解本地区新生儿感染性肺炎的病原菌的菌种、构成比及耐药情况,探索临床合理选用抗生素。方法细菌鉴定及药敏试验采用VITEK-60全自动细菌鉴定仪。结果本地区新生儿感染性肺炎的病原菌主要为革兰阴性杆菌(92.81%),其中以肺炎克雷伯菌最为常见,革兰阳性球菌感染较少(7.19%)。革兰阴性杆菌对头孢二代、三代和氨基糖苷类抗生素的耐药率均较高,对喹诺酮类抗生素耐药率较低。亚胺培南具有良好的抗菌活性。结论肺炎克雷伯菌是本地区新生儿感染性肺炎的主要病原菌。经验性治疗用药可首选亚胺培南、头孢替坦、环丙沙星等,建议临床根据药敏结果选用抗生素。

Objective To investigate the pathogenic bateria of neonatal infective pneumonia in Shantou area. Method The identification of bacteria and susceptibility test were performed by AMS VITEK-60. Reslut Gram-negative bacteria were the prominent pathogens, which accounted for 92.81% （ 142/153 ） of the pathogens in neonatal infective pneumonia. The most common pathogens were Klebsialla pneumonia. There were less pathogens of Gram-positive bacteria found in the neonatal infec- tive pneumonia. The resistance rates of Gram-negative bacteria to eephalosporins and aminogiycosides were significantly higher than to imipenem and fluroguinlones. Conclusion Klebsialla pneumonia is the prominent pathogen of neonatal infective pneumonia in Shantou area. The first choices of antibiotics in treating Gram-negative bacteria infection are imipenem, cefotetan and ciprofloxaein. Use of antibiotics in clinical therapy should be based on the results of susceptibility of pathogens.