新生儿多重耐药菌感染性肺炎62例临床分析

The Clinical Analysis of 62 Cases with Neonatal Pneumonia Caused by Multidrug-Resistant Organism

目的:回顾性分析贵州省黔西南州人民医院新生儿多重耐药菌(MDRO)感染性肺炎的病原菌分布及耐药情况,为合理用药提供依据。方法:选取2011年3月至2012年2月该院新生儿病房确诊的MDRO感染性肺炎62例为研究对象,分析病原菌种类及其药敏试验结果。结果:62例MDRO中革兰阴性菌51例,占82.3%,革兰阳性菌11例,占17.7%。革兰阴性菌主要为大肠埃希菌、肺炎克雷伯菌,其对亚胺培南、美罗培南敏感率为100%,对哌拉西林/他唑巴坦敏感率为94.1%。革兰阳性菌均为葡萄球菌,对万古霉素敏感率为100%。结论:该院新生儿MDRO感染性肺炎的主要病原菌为革兰阴性菌中的大肠埃希菌、肺炎克雷伯菌,治疗首选亚胺培南、美罗培南,因其对哌拉西林/他唑巴坦敏感率也高,且哌拉西林/他唑巴坦价格低廉,故哌拉西林/他唑巴坦可作为优选药。

Retrospective analyze on pathogenic bacteria of pneumonia caused by multidrug-resistant organism （MDRO） and its drug resistance situation in the People＇s Hospital of Southwest of Guizhou Province, and provide the reference for rational therapy. Methods： Selected 62 cases of confirmed MDRO infectious pneumonia from March 2011 to February 2012 as the research object, analyzed the types of pathogenic bacterium and antibiotic sensitivity. Results： Among the 62 cases of MDRO infectious pneumonia, 51 cases were gram negative bacteria, accounting for 82.3% , 11 cases were gram positive bacteria, accounting for 17.7%. Gram-negative bacteria were mainly Escherichia coli and Cray Borrelia bacteria, the sensitivities of E. coli and K. pneumoniae were 100% to imipenem and meropenem and 94.1% to piperazone/tazobactam. Gram-positive bacteria were Staphylococcus aureus, the sensitivity to vancomycin rate was 100%. Conclusions： The predominant pathogenic bacteria of neonatal MDRO infectious pneumonia are Gram-negative bacteria： Escherichia coli and Cray Borrelia bacteria. Imipenem or meropenem is the first choice for the treatment. The sensitivity to piperacillin/tazobactam is also high, so it can be used as the preferred drug for its high sensitivity and low price.