新生儿临床标本抗生素敏感性分析

Antimicrobial Susceptibility of Bacteria Causing Neonatal Infections

目的 :探索新生儿感染病原菌分布及常见抗菌药物敏感性 ,为经验性治疗提供依据。方法 :按《全国临床检验操作规程》鉴定细菌 ,纸片扩散法做药敏试验。结果 :1987～ 1998年内分离出病原菌 2 2 44株。院外感染前三位是表皮葡萄球菌、腐生葡萄球菌及大肠埃希菌 ,院内感染前三位是大肠埃希菌、克雷白菌及绿脓杆菌。院内外感染菌株对青霉素、氨苄西林等 15种抗生素的耐药率差异显著。阿米卡星的总敏感率 86.2 % ,与青霉素联用敏感率增至 89.0 %。结论 :院外感染致病菌以革兰阳性菌为主 ,而院内感染致病菌以革兰阴性菌为主 ,后者对许多抗菌药物更易产生耐药性 ,阿米卡星联合青霉素作为第一线抗菌药物值得推广。

Objective:To investigate the epidemiological characteristics of bacteria and their susceptibility to antimicrobials and to establish a basis for empirical treatment of the neonatal infections. Methods:Identification of bacteria were performed according to the National Standard of Clinical Microbiological Test. Disk diffusion were used for antimicrobial susceptibility test. Results: A total of 2,244 strains were isolated from the samples collected in our neonatal ward from Jan. 1987 to Dec. 1998. The predominant species ranked the first three were Staphylococcus epidermidis, Staphylococcus saprophyticus and Escherichia coli in the group I (infections acquired outside of hospital). Escherichia coli, Klebsiella and pseudomonas aeruginosa ranked the first three in the group Ⅱ(nosocomial infections). The resistance rates of bacterial isolates from group Ⅱ to antimicrobial agents including penicillin and ampicillin were significantly higher than that from group I (P<0.05). The sensitivity rate was 82.2% by using amikacin only, but raised to 89% when combined with penicillin. Conclusion: Gram-negative bacteria were the main pathogens of nosocomial infections of neonates in our hospital but Gram-positive bacteria were the main pathogens of infections acquired outside of hospital. The nosocomial pathogens were more prone to developing drug resistance. It is recommended that the combinative use of amikacin and penicillin be employed as primary antibiotics for treatment of neonatal infections.