NICU新生儿感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing infections in neonates of NICU

目的探讨新生儿重症监护病房(NICU)病原菌分布及耐药性,为临床合理用药提供科学依据。方法选取2011年3月-2013年10月NICU感染患儿360例,采集患儿血液等标本进行病原菌检测和药物敏感试验,分析病原菌分布及其耐药性。结果 360例患儿共分离出病原菌395株,其中革兰阴性菌232株占58.7%,革兰阳性菌129株占32.7%,真菌34株占8.6%;革兰阴性菌对喹诺酮类、氨基糖苷类、第三代头孢菌素等抗菌物耐药率较高,多数>90.00%,部分达100.00%,耐药率较低的是亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦,主要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>90.00%,部分达100.00%,真菌的耐药率普遍较低。结论 NICU患儿感染病原菌分布以革兰阴性菌为主,临床用药应该尽量避免经验用药,根据药敏结果进行针对性选择用药。

OBJECTIVE To explore the distribution and drug resistance of pathogens isolated from neonatal inten-sive care unit （NICU）so as to provide scientific basis for reasonable clinical use of antibiotics.METHODS A total of 360 neonates with infections who were treated in the NICU from Mar 2011 to Oct 2013 were enrolled in the study,then the blood specimens were collected from the neonates for the culture of pathogens,the drug suscepti-bility testing was performed,and the distribution and drug resistance of the pathogens were observed.RESULTS Totally 395 strains of pathogens have been isolated from the 360 neonates,including 232 （58.7%）strains of gram-negative bacteria,129 （32.7%）strains of gram-positive bacteria,and 34 （8.6%）strains of fungi.The drug resistance rates of the majority of gram-negative bacteria to quinolones,aminoglycosides,and the third generation cephalosporins were more than 90.00%,the drug resistance rates of a few of species even reached 100.00%,and the drug resistance rates to imipenem,cefoperazone-sulbactam,and piperacillin-tazobactam were relatively low. The drug resistance rates of the main gram-positive bacteria to clindamycin,levofloxacin,erythromycin,and peni-cillin were more than 90.00%,the drug resistance rates of a few of species reached 100.00%.The drug resistance rates of the fungi were low.CONCLUSION The gram-negative bacteria are the predominant pathogens causing in-fections in the neonates of NICU.It is necessary for the hospital to try to avoid the empirical medication and rea-sonably use antibiotics on the basis of the results of the drug susceptibility testing.