新生儿常见致病菌对青霉素与氨苄西林的耐药性值得重视

The resistances of penicillin and ampicillin to common pathogenic bacteria isolated from neonates with infections

目的 为探讨青霉素和氨苄西林对新生儿常见致病菌的耐药情况,方法 于1987年～1998年分离病原菌2244株,用K-B纸片扩散法做药敏试验,结果 对青霉素耐药率高达83.1％;对氨苄西林达85.2％,90年代明显高于80年代(x^2=33.442,P=0.001),对革兰阳性致病菌与阴性致病菌均有较高的耐药性,尤其是对革兰阴性菌更为严重,高达95.2％。院内感染组较院外感染组总耐药率显著性增高(对青霉素92.0％比81.6％,(X^2=11.363,P=0.001),对氨苄西林96.0％,比82.7％,(X^2=28.287,P=0.001),同时做了两抗生素药敏试验578株细菌中敏感率分别仅为16.3％和18.9％,联合敏感率仅21.6％,X^2=2.116,P=0.146。结论 青霉素和氨苄西林在新生儿致病菌中的耐药性非常严重。

Objective To search the resistances of penicillin and ampicillin to common bacteria causing neonal infections. Methods 2244 strains were isolated from 1987 to 1998 and their antibiotic susceptibility tests were performed by using K - B disk diffusion tests. Results The resistant rates of penicillin and ampicillin were 83. 1% and 85. 2% , respectively. Ampicillin had significantly higher resistant rates in 1990' s than in 1980' s(87. 5% versus 69. 9% , X2 = 33. 442P = 0. 001) . There were higher resistant rates to ampicillin both in Gram - negative and Gram - positive bacteria, and more seriously in Gram - positive bacteria whose resistant rates were 95. 2%. The general resistant rates were higher in group of nosocomial infections than group of infections acquired outside of hospital (to penillin, 92. 0% versus 81. 6% , x2 = 11. 363, P = 0.001; to ampicillin, 96. 0% versus 82. 7% , x2 =28. 287, P = 0.001). The sensitivity rates of 578 strains bacteria to penicillin and ampicillin were only 16. 3% and 18. 9%, respectively, and the combined susceptibility tests were only 21. 6% , x2 = 2. 116, P = 0. 146. Conclusion There are quite serious resistances of penicillin and ampicillin to pathogenic bacteria isolated from neonates with infections.