新生儿肺炎革兰阳性菌分布及耐药性

Distribution and drug resistance of Gram-positive bacteria causing pneumonia in neonates

目的探讨新生儿感染性肺炎革兰阳性菌分布及耐药性,为临床预防及诊治提供参考依据。方法对310例临床诊断为新生儿感染性肺炎患儿痰液进行细菌培养和耐药性检测。结果310例肺炎患儿中,共检出病原菌151株,阳性率为48.7%,革兰阳性菌49株,占32.5%,主要为金黄色葡萄球菌和表皮葡萄球菌,共39株。革兰阳性菌对青霉素、氯林可霉素、红霉素耐药率高,仅对万古霉素敏感。葡萄球菌中耐甲氧西林葡萄球菌(MRS)22株,总分离率为56.4%,耐甲氧西林金黄色葡萄球菌(MRSA)10株占40.0%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)12株占85.7%。结论革兰阳性菌是新生儿肺炎的主要病原菌,开展细菌耐药性的监测对新生儿科抗菌药物的合理应用,提高疗效,减缓耐药菌株的发生与发展有重要意义。

Objective To study the distribution and drug resistance of Gram positive bacteria causing pneumonia in neonates, and provide guidance for clinical diagnosis and treatments. Methods Bacteria were cultured from 310 neonatal pneumonia patient sputum samples for the drug sensitivity test. Results 151 strainspathogenic bacteria were isolated,of which 49 strains （32.5%） were Gram-positive bacteria. The common detected bacteria included Streptococcus pneumonia. The major Gram-positive bacteria were almost resistance to penicillin, clindamycin and erythromycin but sensibility to vancomycin. Methicillin resistant Staphylococcus （MRS） had 22 strains; Methicillin resistant Staphylococcus aureus （MRSA） had 10 strains; Methicillin resistant coagulase negative Staphylococcus （MRCNS） had 12 strains. Conclusion Gram-positive bacteria were the main pathogenic bacteria of neonatal pneumoniaand it is essential to have drug sensitive analysis for the reasonable application of antibiotics in pediatrics to improve therapeutic efficacy and prevent the occurrence and development of the resistant strains of microorganisms .