NICU患儿感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens for infection in NICU infants

目的探讨新生儿重症监护病房(NICU)患儿感染病原菌分布及耐药性,为临床抗菌药物的合理使用提供参考依据。方法选取2011年9月-2013年9月NICU送检各类细菌培养标本2 632份,对其分离后病原菌分布以及药敏进行分析,药物敏感试验采用K-B纸片扩散法,参照NCCLS的2004年版本。结果 2 632份标本共检出586株病原菌,检出率为22.26%,其中革兰阴性菌421株占71.84%,革兰阳性菌123株占20.99%,真菌42株占7.17%;革兰阴性菌对于氨曲南、氨苄西林、氨苄西林/舒巴坦、头孢曲松、头孢唑林具有较高的耐药性,均>85.00%;革兰阳性菌对克林霉素、左氧氟沙星、红霉素、青霉素有较高的耐药性,多数可达100.00%;真菌的耐药率普遍较低。结论肺炎克雷伯菌、大肠埃希菌、葡萄球菌属等为NICU患儿感染常见的病原菌,存在多药耐药性,应根据监测结果要合理临床使用抗菌药物,以减少新耐药株的形成,同时降低医院感染的发生。

OBJECTIVE To investigate the distribution and drug resistance of pathogens for infection in NICU infants so as to provide reference for clinical rational use of antimicrobial drugs .METHODS Totally 2632 speci‐mens of various types of bacteria collected from NICU that were delivered for test during Sep .2011 to Sep .2013 in our hospital were selected .After the separation ,the distribution and the antimicrobial susceptibility of patho‐gens were analyzed .The K‐B disk diffusion method was used for the sensitivity test with reference to NCCLS （2004 edition） .RESULTS Totally 586 strains of pathogens were detected from the 2632 specimens with the detec‐tion rate of 22 .26% ,of which there were 421 strains of gram‐negative bacteria （71 .84% ） ,123 strains of gram‐positive bacteria （20 .99% ） ,and 42 strains of fungi （7 .17% ） .Gram‐negative bacteria had high resistances of ＆gt;85 .00% to aztreonam ,ampicillin ,ampicillin/sulbactam ,ceftriaxone ,and cefazolin .Gram‐positive bacteria had high resistances to clindamycin , levofloxacin , erythromycin , and penicillin , with most resistances of up to 100 .00% .Fungal resistance was generally low .CONCLUSION K lebsiella pneumoniae ,Escherichia coli ,Staph‐ylococcus aurous are the common pathogens for infection ,and present with multiple drug resistances .The antimi‐crobial drugs should be reasonably used according to the monitoring results so as to reduce the formation of new resistant strains and reduce the incidence of nosocomial infection .