医院感染新生儿败血症病原菌分布及药敏结果分析

Distribution and Drug Sensitivity of Nosocomial Infection Neonatal Septicemia

目的:分析医院感染新生儿败血症病原菌的分布情况及其药敏试验结果,为临床提供参考。方法:通过医院信息系统(HIS)对湖北省咸宁市咸安区妇幼保健院新生儿科2013年6月至2015年6月6 985例败血症患儿的血培养及药敏试验结果进行统计分析。结果:6 985例血培养标本中共184例分离出病原菌,通过双侧不同部位采血进行血培养,剔除61例污染菌及非院内感染病原菌,共获得123例医院感染病原菌标本,检出率1.76%(123/6 985)。新生儿败血症医院感染病原菌中,表皮葡萄球菌居首位(27.64%,34/123),其次为大肠埃希菌(26.83%,33/123)。革兰阳性球菌中耐甲氧西林葡萄球菌比例较高,对万古霉素敏感;革兰阴性杆菌对第二代、第三代头孢菌素的耐药率较高,对含酶抑制剂和碳青霉烯类较敏感。结论:医院感染新生儿败血症病原菌耐药率较高,临床应加强血培养检查,根据药敏试验结果针对性用药以达到较好的治疗效果。

Objective： To analysis the pathogenic bacteria distribution and drug sensitivity test results of nosocomial infection neonatal septicemia in hospital, to provide a powerful test basis for clinical diagnosis and treatment. Methods： From June 2013 to June 2015, 6,985 cases of blood culture results were statistically analyzed by hospital HIS system in Xian＇ an Maternal and Child Health Hospital of Xianning. Results： A total of 184 pathogenic bacteria were isolated from 6,985 blood culture samples, through different parts on both sides of blood collection for blood cultures, 61 cases of contaminated bacteria and the non-nosocomial infection pathogens were rejected, a total of 123 cases of nosocomial infection pathogens specimens were selected, detection rate was 1.76% （ 123/6,985 ）. Staphylococcus epidermidis ranked first, accounted for 27.64% （ 34/123 ）, followed by Escherichia coli, accounted for 26. 83% （ 33/123 ）. The percentage of methicillin-resistant Staphylococcus aureus in gram positive coccus was high, which was sensitive to vancomycin. Gramnegative bacilli resisted to second and third generation of cephalosporin, was sensitive to Penicillium containing enzyme inhibitors and carbapenems. Conclusion： The situation on antibiotic resistance of hospital infection pathogen of neonatal sepsis becomes more and more severe. Therefore, it is urgent to strengthen the surveillance of antimicrobial susceptibility of pathogen and monitor drng-resistant strains timely to guide clinical treatment and prevention.