新生儿败血症342例常见病原菌分布及耐药性分析

Analysis of drug resistance and the distribution of common pathogens of 342 cases of neonatal sepsis

目的研究新生儿败血症的临床常见病原菌分布以及抗菌药的耐药性，为临床合理使用抗生素药物提供理论基础。方法选择342例新生儿败血症患儿作为研究对象，采用病例对照研究方法，回顾性收集患儿的临床资料和血培养标本，了解新生儿败血症患儿的病原菌培养情况，分析病原菌的分布及耐药性结果。结果342例新生儿败血症感染率为5．4％，其中早产儿败血症患儿136例，感染率为10．9％，足月产败血症患儿206例，感染率为4．0％，早产儿败血症感染率高于足月产败血症（x。：88．07，P〈0．01）；早产儿败血症和足月儿败血症病原菌菌株分布差异无统计学意义（P〉0．05）。新生儿败血症常见的两种革兰阳性菌凝固酶阴性葡萄球菌和金黄色葡萄球菌对青霉素耐药，耐药率分别为97．1％和87．5％，其次对红霉素耐药性分别为86．9％和75．0％；三种常见革兰阴性菌均对抗生素亚胺培南敏感，对氨苄西林和头孢唑林耐药，耐药率均为100．0％，其次是哌拉西林、头孢吡肟、头孢噻肟和头孢他啶。结论新生儿败血症革兰阳性菌主要以凝固酶阴性葡萄球菌和金黄色葡萄球菌为主，革兰阴性菌以克雷伯菌、大肠埃希菌和大肠杆菌为主，常见病原菌具有耐药性，临床治疗时应合理应用抗生素类药物，加强耐药性监测。

Objective To analyze clinical common pathogenic bacteria distribution of neonatal sepsis and antimicrobial resistance,in order to provide theoretical basis for clinical rational use of antibiotics. Methods 342 cases of neonatal sepsis were selected as the research objects,through the case control study, specimens were collected retro- spectively the clinical data and blood culture, to understand the pathogenic bacteria children with neonatal septicemia culture,To understand the pathogenic bacteria in children with neonatal septicemia culture. Distribution and drug resistance of pathogenic bacteria were analyzed. Results 342 cases of neonatal septicemia infection rate was 5.4%, among the 136 cases of preterm infants with sepsis,infection rate is 10.9% ,206 cases of full- term infants with sep- sis, infection rate was 4.0%, Septicemia in premature infants infection than full - term sepsis （ X2 = 88.07, P 〈 0. 01 ） ; No significant difference of septicemia in premature infants and full - term infants septicemia pathogen strain distribution（ P 〉 0.05 ）. Coagulase negative Staphylococcus aureus and Staphylococcus aureus resistant to penicillin, drug resistance rates were 97.1% and 87.5%, secondly to erythromycin resistance, respectively were 86.9% and 75.0% ; Three kinds of common gram negative bacteria were sensitive toimipenem, resistance to ampicillin and cefazo- lin, drug resistance rate was 100.0%, the second was piperacillin, cefepime, cefotaxime and ceftazidime. Conclusion Neonatal septicemia of gram positive bacteria mainly coagulase negative Staphylococcus aureus and Staphylococcus aureus, gram negative bacteria mainly in grams of Klebsiella pneumoniae, Escherichia coli and Escherichia coli. Common pathogenic bacteria with drug resistance. Clinical treatment of neonatal sepsis should be rational use of anti- biotics, to strengthen the monitoring of drug resistance.