新生儿败血症23例病原菌及其耐药性分析

Pathogens and drug sensitivity test in 23 cases of neonatal septicemia

目的了解引起新生儿败血症的主要病原菌及其对药物的敏感性情况,为临床治疗提供依据。方法对该院23例新生儿败血症患儿进行回顾性分析,用K-B法进行药敏实验,并按CLSI标准判断病原菌耐药性。结果 23例标本均为单一菌种生长,革兰阳性球菌21株(87.0%),主要包括B族链球菌(GBS)9株(39.1%),表皮葡萄球菌7株(30.4%),溶血葡萄球菌2株(8.7%),以凝固酶阴性葡萄球菌(CNS)为主;革兰阴性杆菌3株(13.0%),主要包括大肠埃希菌及肺炎克雷伯氏菌各1株(4.3%),以肠杆菌为主。新生儿败血症感染的病原菌,普遍对青霉素类、头孢类和大环内酯类抗菌药物耐药,而对氨基糖苷类、喹诺酮类、万古霉素和复方磺胺甲恶唑敏感。结论该院新生儿败血症的病原菌以CNS和GBS为前2位,在防治过程中,应及早进行病原学检测及药敏试验,合理选用抗菌药物。

Objective To study the pathogens and drug sensitivity test of neonatal septicemia to direct the uses of antibiotics.Methods The clinical data of 23 cases of neonatal septicemia were analyzed retrospectively.All of the isolates were tested by Kirby-Bauer susceptibility,and the antibiotic resistance was judged according to CLSI standard.Results A total of 23 episodes of sepsis were identified in 23 neonates.Gram-positive coccus were the main pathogens（87.0%）,including 9 cases of Group B Streptococci（GBS）（39.1%）,7 Staphylococcus epidermidis（30.4%）,2 Staphylococcus hemolyticus（8.7%）.3 cases of Gram-negative bacillus（13.0%）,among which 4.3% were Escherichia coli and Klebsiella pneumoniae.The antibiotics to which all of the bacteria with high resistance included penicillins,cephalosporins and macrolides.The aminoglycosides,quinolones,vancomycin and Trimethoprim/Sulfamethoxazole were the most sensitive drugs presently.Conclusion CNS and GBS were the top two pathogens in neonatal septicemia,according to pathogen detection and drug susceptibility testing early,choosing sensitive antibiotics.