NICU中新生儿败血症病原菌分布及耐药性分析

Pathogen Distribution and Drug Resistance Analysis of Neonatal Sepsis in NICU

目的：对我院2008年1月至2013年1月NICU中新生儿败血症的病原菌进行分析并探讨临床治疗败血症患儿的早期最佳药物选择。方法：分析我院NICU 75例新生儿败血症患儿临床资料、血培养结果,根据细菌培养阳性结果及药敏情况进行药物选择。结果：75例血培养阳性新生儿败血症共获得92株细菌,其中革兰阳性球菌58株（63.04%）,革兰阴性杆菌31株（33.70%）,另有3株（3.26%）为真菌。本次检出的病原菌对青霉素和红霉素等常用抗菌药物耐药性很高,总耐药率高达90%。革兰阴性杆菌对氨苄西林、头孢唑林耐药率较高在85%左右,对哌拉西林、头孢他啶、头孢曲松的耐药率偏高,总耐药率在25%-50%。结论：我院NICU中新生儿败血症病原菌以革兰阳性球菌为主,且耐药率较高,要警惕真菌感染可能。

Objective： To investigate the pathogen distribution and drug resistance of neonatal sepsis in NICU,in order to provide reference for clinical drug selection in early stage. Methods： Clinical datum,result of blood culture of seventy-five cases with neonatal sepsis in NICU of our hospital were analyzed. Selected the rational drug based on pathogens distribution and drug resistance. Results：The positive blood culture of 75 samples were mainly found in neonatal sepsis in NICU. A total of 92 strains bacteria were detected.Gram-positive cocci were 58 strains,accounting for 63. 04%,Gram-negative bacillus were 31 strains,accounting for 33. 70%,fungi were 3 strains accounting for 3. 26%. The drug resistance rates to penicillin,erythromycin and other commonly used antibiotics were more than 90%. The drug resistance rates of Gram-negative bacillus to ampicillin,cefazolin were more than 85%,and the drug resistance rates of Gram-negative bacillus to piperacillin,ceftazidime,ceftriaxone were 25% to 50%. Conclusion： The main pathogen of neonatal sepsis in NICU was Gram-positive cocci,their drug resistance rates were high. The possible fungal infection should be alerted.