新生儿血培养病原菌分布及耐药分析

Analysis of pathogen distributions and antibiotic resistances in neonatal blood cultures

目的：分析新生儿血培养病原菌分布及耐药特征，为治疗新生儿败血症、合理使用抗菌药物提供科学依据。方法回顾性统计分析2014-01～2014-12新生儿血培养的临床资料。结果新生儿血培养阳性率为6.2％（280／4512）。280份标本共检出295株病原菌，其中以革兰阳性球菌为主，共212株，占71.9％（212／295），其中凝固酶阴性葡萄球菌（CNS）占59.0％（174／295）；革兰阴性杆菌69株，占23.4％（69／295）；其他病原菌14株，占4.7％（14／295）。 CNS对青霉素、四环素、庆大霉素、苯唑西林耐药率为60.0％～100.0％，对万古霉素、替考拉宁、呋西地酸、呋喃妥因、米诺环素耐药率低，为0.0％～15.8％。肺炎克雷伯杆菌、大肠埃希菌对阿莫西林、头孢噻吩、头孢呋辛耐药率高，为79.5％～97.4％。结论新生儿血培养病原菌以CNS为主，CNS及革兰阴性杆菌对常用抗菌药物耐药率高，应加强耐药监测，合理使用抗菌药物。

Objective To investigate pathogen distribution and antibiotic resistance characteristics in neo-natal blood cultures and provide a scientific basis for the treatment of neonatal septicemia and the rational use of anti-biotics.Methods The clinical data of neonatal blood cultures were statistically analyzed retrospectively from January 2014 to December 2014.Results The positive rate of blood cultures was 6.2%（280/4512）.Gram-positive coccus were the predominant, accounting for 71.9%（ 212/295 ） , among which coagulase negative staphylococcus （ CNS ） were 59.0%（174/295）;Gram-negative bacteria, accounted for 23.4%（69/295）, other pathogens 14 strains, ac-counted for 4.7%（14/295）.The resistant rates of CNS to penicillin, tetracycline, gentamicin and oxacillin were be-tween 60.0%and 100.0%.The resistant rates of CNS to vancomycin, teicoplanin, fusidicacid, nitrofurantoin, and minocycline were low, ranging from 0.0%to 15.8%.The resistant rates of Klebsiella pneumoniae and Escherichia coli to cephalothin, cefuroxime and amoxicillin were between 79.5%and 97.4%.Conclusion CNS are the predom-inant pathogens in the neonatal blood cultures and the resistance rates of CNS and some Gram-negative bacilli to some frequently-used antibacterials are high.It is necessary to take measures to monitor the drug resistance of strains and use antibacterials reasonably.