我院2013年1-10月早发型与晚发型新生儿败血症细菌耐药性及抗菌药物使用分析

Analysis of Bacterial Resistance and Antibiotics of Early and Late-onset Neonatal Sepsis in Our Hospital during Jan.-Oct. in 2013

目的:了解我院早、晚发型新生儿败血症的病原菌分布特征、细菌耐药性及抗菌药物的使用状况,为临床诊治新生儿败血症提供参考依据。方法:对我院2013年1-10月117例第一诊断为新生儿败血症的出院患儿进行回顾性分析。结果:早发型败血症86例,晚发型败血症31例。两组均以凝固酶阴性葡萄球菌感染最多,其次是大肠埃希菌。凝固酶阴性葡萄球菌对利福平、万古霉素高度敏感;大肠埃希菌对庆大霉素、哌拉西林/他唑巴坦、左氧氟沙星、美罗培南、亚胺培南高度敏感。头孢噻肟为使用最多的抗菌药物(早发型66.28%,晚发型35.48%)。治愈103例(88.03%),好转7例(5.98%),无效(自动出院)7例(5.98%)。结论:败血症仍为新生儿疾病中一个较为突出的问题,临床迫切需要高特异性和高敏感性的诊断方法及合理治疗方案。

OBJECTIVE： To investigate the distribution of pathogens, bacterial resistance and the application of antibiotics of early and late-onset neonatal sepsis in our hospital, and to provide reference for clinical diagnosis and treatment. METHODS： 117 discharged children diagnosed as neonatal sepsis in our hospital from Jan. to Oct. 2013 were analyzed retrospectively. RESULTS： There were 86 cases of early-onset sepsis （EOS） and 31 cases of late-onset sepsis （LOS）. Coagulase-negative staphylococcus （CONS） was the most common organism cultured for both EOS and LOS, followed by Escherichia coil CoNS was highly sensitive to rifampicin and vancomycin; E. coli was highly sensitive to gentamicin, piperacillin sodium/tazobactam sodium, levofloxacin, meropenem, imipenem. Cefotaxime was the most frequently used antibiotics （EOS 66.28%, LOS 35.48% ）. 103 cases were cured （88.30 % ）, 7 cases were recovered （5.98 %） and 7 cases were inactive （automatic discharge, 5.98 % ）. CONCLUSIONS： Sepsis re- mains a significant problem in neonatal ward. It is urgent to establish diagnostic tests both with high specificity and sensitivity, as well as evidence-based rational treatment strategies.