新生儿败血症60例临床分析

Clinical Analysis of 60 Cases of Neonatal Septicemia

目的:探讨近年来我院新生儿病房收治的新生儿败血症的临床表现、病原菌分布及药敏特点,以指导临床治疗。方法:回顾性分析本院新生儿病房2011年5月-2013年5月经血培养确诊为新生儿败血症的60例患儿的资料。结果:新生儿败血症临床表现缺乏特异性,以少吃、少动、少哭,体温波动、黄疸等表现为主。研究期间共检出病原菌60株,其中革兰氏阳性菌60%,革兰氏阴性菌40%,排在前5位分别是表皮葡萄球菌、大肠埃希菌、溶血性葡萄球菌、肺炎克雷伯菌、阴沟肠杆菌。革兰氏阳性菌对青霉素、苯唑西林、红霉素耐药率高,对万古霉素、利福平尚未耐药;但部分溶血性葡萄球菌对青霉素、苯唑西林敏感。革兰氏阴性菌对氨苄西林、头孢类、氨曲南耐药性高,对哌拉西林他唑巴坦、碳青霉烯类尚未耐药,但阴沟肠杆菌对头孢三代以上仍敏感性高。结论:根据病原菌及其耐药性检测选用敏感药物治疗新生儿败血症,可减少耐药菌株的产生,提高治疗效果。

Objective： To investigate clinical presentations, The distribution ot pathogemc bacteria ana arug resistance characteristics of neonatal septicemia in neonatal ward of our hospital in recent years, to guide the clinical treatment. Methods： Retrospectively analysis was performed on the clinical data of 60 neonates with septicemia hospitalized from 2011 May to 2013 May. Results：The clinical manifestations of neonatal septicemia lack of specificity, with fever, iaundice, eat less, reaction and poor performance. During the study period, there were 60 strains of pathogenic bacteria, including 60 % gram positive bacteria, 40 % gram negative bacteria, In the top 5 were Staphylococcus aureus, Escherichia coil,Staphylococcus haemolyticus, Klebsiella pneumoniae, Enterobacter cloacae. Escept Part of Staphylococcus haemolyticus is sensitive to the penicillin and oxacillin, other Gram positive bacteria have high durg-resistant on the penicillin, oxacillin, erythromycin, but no such resistant was observed for rifampicin, vancomycin. Eseept Part of Enterobacter cloacae is sensitive to the cefotaxime sodium, ceftazidime, other Gram negative bacteria have high durg-resistant on the ampicillin, cephalosporin, aztreonam, but no such resistant was observed for Tazobactam Sodium/Piperacillin Sodium for Injectio,carbopenems. Conclusion：According to the detection of pathogenic bacteria and their drug resistance to select sensitive drugs in the treatment of neonatal septicemia, which can reduce the emergence of resistant strains, improve the therapeutic effect.