新生儿脐炎脐部分泌物病原菌分布及耐药性分析

Study on 69 Pathogens and Drug-resistance of Neonatal Omphalitis

目的:掌握新生儿脐炎脐部分泌物病原学分布及药物敏感情况,为儿科医师的治疗及疾病预防提供依据。方法:对2011年7月～2012年11月收治的74例新生儿脐炎患儿进行脐部分泌物的常规细菌培养鉴定,用K-B法测定病原菌耐药性。结果:共分离病原菌69株,其中金黄色葡萄球菌23株,占33.33%,大肠埃希菌17株,占24.64%,肺炎克雷伯菌肺炎亚种8株,占11.59%。MRSA分离率为4.35%(1/23),MRCNS分离率为40.00%(2/5);产ESBLs大肠埃希菌和肺炎克雷伯菌肺炎亚种分别为47.06%(8/17)、50.00%(4/8)。结论:新生儿脐炎的主要病原菌为金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌肺炎亚种、凝固酶阴性葡萄球菌等,耐药情况严峻,应加强新生儿脐部护理;加强细菌耐药性监测有助于指导儿科医师合理选择抗菌药物。

Objective： To investigate the distribution and drug resistance of clinical isolates in omphalitis,and to provide basis to choose rational antibiotics for prevention and treatment of neonatalomphalitis.Methods： Bacteria culture and antibiotic sensitivity test were undertaken for infected navel secretion of 74 newborn cases selected from July 2011 to Nov 2012.The antimicrobial susceptibility test was carried out by Kirby-Bauer method.Results： A total of 69 strains of pathogens were isolated from samples,which included Staphylococcus aureus（23,33.33%）,Escherichia coli（17,24.64%）,Klebsiella pneumoniae（8,11.59%）.MRSA and MRCNS occupied 4.35%（1/23） and 40.00%（2/5）.E.coli and K.Penumoniae of ESBLS accounted for 47.06%（8/17） and 50.00%（4/8）.Conclusions： The main pathogentic bacteria of the newborn omphlitis are Staphylococcus aureus,Escherichia coli,Klebsiella pneumoniae and coagulase negative staphylococcus.It is necessary to advice how attend to the newborn in order to decrease the neonatal omphalitis.Surveillance of antimicrobial resistance can help pediatricians use antimicrobial agents rationally.