新生儿血培养阳性病原菌分布及耐药状况分析

Distribution and drug resistance of the pathogens from blood samples in newborns

目的了解本院新生儿血培养阳性标本病原菌分布情况及主要病原菌的耐药特点,为临床合理治疗提供依据。方法对我院新生儿科4 750例患儿入院时行血培养,并以VITEK32全自动微生物分析仪进行菌株鉴定,K-B法进行药敏试验。结果共分离出病原菌617株,其中革兰阳性菌382株(61.91%),前三位为凝固酶阴性葡萄球菌(41.49%)、金黄色葡萄球菌(7.94%)和肠球菌属(6.00%),革兰阴性菌216株(35.01%),前四位为大肠埃希菌(12.97%)、肺炎克雷伯菌(9.08%)、粘质沙雷菌(5.51%)和阴沟肠杆菌(4.86%),真菌19株(3.08%)。药敏结果显示主要革兰阳性菌对青霉素G耐药率>90%,对利福平和呋喃妥因的耐药率较低,未检出耐利奈唑烷和万古霉素菌株。主要革兰阴性菌对阿米卡星、左氧氟沙星、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦耐药率较低,未检出耐亚胺培南、美罗培南和替加环素菌株。结论本院新生儿血培养病原菌以革兰阳性菌为主,凝固酶阴性葡萄球菌是主要病原菌,并且耐药率较高。

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood specimens of newborns,so as to provide evidence for clinical prevention and treatment. Methods 4,750 blood samples from newborn ward were cultured. VITEK32 was used for strains identification and K-B was used for drug sensitivity test. Results A total of 617 strains of pathogenic bacteria were isolated,including 382 strains of grampositive bacteria（ 61. 91%）,the top three of which were Coagulase-negative Staphylococcus（ 41. 49%）,Staphylococcus aureus（ 7. 94%） and Enterococcus（ 6. 00%）,as well as 216 strains（ 35. 01%） of Gram-negative bacteria,the top four of which were Escherichia coli（ 12. 97%）,Klebsiella pneumoniae（ 9. 08%）,Serratia marcescens（ 5. 51%） and Enterobacter cloacae（ 4. 86%）. There were 19 strains（ 3. 08%） of fungi. The drug resistances of main gram-positive bacteria to Penicillin G were over 90%,while the resistances to Rifampicin and Nitrofurantoin were lower; no Vancomycin and Linezolid resistant strains were found. The resistances of main Gram-negative pathogens to Amikacin,Levofloxacin,Piperacillin / Tazobactam and Cefoperazone / Sulbactam were low. No Imipenem,Meropenem and Tigecycline resistant strains were found. Conclusion Gram-positive bacteria were the main pathogens in the hosptial,among which Coagulase-negative Staphylococcus was the predominant pathogen with high drug resistance.