新生儿败血症早产儿与足月儿的病原学特点分析

Etiological analysis of neonatal sepsis in preterm and term infants

目的探讨新生儿败血症早产儿与足月儿的病原菌构成及耐药性状况,为临床合理用药提供依据。方法回顾性分析西北妇女儿童医院2012年1月1日至2014年12月31日经临床和血培养确诊的97例早产儿与43例足月儿败血症的病原学资料,并对其进行统计学分析。结果革兰氏阳性球菌在足月儿组中检出比例高于早产儿组(χ2=15.36,P<0.01),真菌仅在早产儿组中检出(χ2=8.57,P<0.01)。葡萄球菌和肠杆菌对常用抗菌药物耐药严重,且呈多药耐药。万古霉素、利奈唑胺、亚胺培南未发现耐药株。结论早产儿与足月儿败血症在病原菌方面存在一定差异,早产儿易发生真菌性感染。检出的葡萄球菌和肠杆菌对常用抗菌药物耐药严重,应引起重视。

Objective To evaluate the pathogenic bacterium constitution and drug resistance of neonatal sepsis in preterm and term infants,so as to provide evidence for reasonable medication in clinics. Methods The pathogenic data of 97 preterm and 43 term cases of neonatal sepsis diagnosed in department of neonatology in Northwest Women and Children Hospital from January 1,2012 to November 31,2014 were retrospectively analyzed. Statistical analysis was performed. Results The detection rate of Gram-positive cocci in term infant group was higher than that in preterm infant group（ χ2= 15. 36,P〈0. 01）. Fungal infection was only found in preterm infant group（ χ2= 8. 57,P〈0. 01）. Staphylococcus and enterobacteria were highly resistant to commonly used antibiotics and demonstrated multi-drug resistance. The pathogenic bacterium resistant to vancomycin,linezolid and imipenem were not found. Conclusion Preterm and term infants with sepsis are somewhat different in pathogenic bacterium. Preterm infants are more likely to suffer fungal infection. Staphylococcus and enterobacteria are highly resistant to commonly used antibiotics,which should attract great attention.