新生儿败血症病原菌分布及耐药性分析

Distribution and Antibiotic Resistance of Pathogens Isolated in 207 Cases of Neonatal Septicemia

目的分析近年梅州市人民医院新生儿败血症病原菌分布以及耐药情况,以指导临床用药。方法用全自动培养仪Bact/ALERT3D120进行全血标本培养,用全自动细菌鉴定系统VITEK-2compact对2009年1月至2011年12月血培养阳性标本所分离出的207株病原菌进行鉴定和药敏实验。结果革兰阳性菌(72.95%)为主要病原菌,其中表皮葡萄球菌(30.43%)居首位,其次为溶血性葡萄球菌(12.08%),另有无乳链球菌(11.59%),均对青霉素完全耐药,未发现耐利奈唑胺、万古霉素菌株;革兰阴性菌(24.64%)主要有大肠埃希菌(9.66%)、肺炎克雷伯菌肺炎亚种(6.76%),二者对氨苄西林敏感性较低,敏感率分别为29.4%、0.0%,对阿米卡星、亚胺培南完全敏感。结论引起该院新生儿败血症的主要病原菌为革兰阳性菌,其中以表皮葡萄球菌居多,临床应根据血培养及药敏结果选用药物,以减少细菌耐药性产生并提高临床疗效。

Objective To analyze the distribution and drug resistance status of the neonatal septicemia in our hospital in recent years,and to guide the clinical medication. Methods Bact/AI.ERT 3D120 automated blood culture system was used to culture blood samples. VITEK-2 compact automicroscan was used to identify and test antibiotic susceptibility of 207 pathogenic strains iso- lated from positive samples in blood culture test from Jan. 2009 to Dec. 2011. Results Gram poMtive bacteria（72. 950%） were the main pathogens,S, epidermidis was the top（30.43%）,S, haemolytieus（12.08%）,S, agalactiae（11. 59%）,all above were totally resistant to penicillin,but had no resistance to linezolid and vaneomycin. E. coli（ 9. 66 % ） and K lebsiella pneumonia（6.76 %） were the main Gram-negative bacteria（ 24.64 % ）, they both had a high resistance to ampieillin（ 29.41% ,0.00 % ）, but were all sensitive to amikacin and imipenem. Conclusion Gram-positive bacteria are the main pathogens causing neonatal septicemia in our hospital,in which S. epidermidis is the most common one. Choosing antibiotics based on drug sensitivity test may decrease the incidence of drug resistance and increase clinical curative effects.