新生儿社区获得性肺炎病原体分布及药敏分析

Distribution and drug susceptibility analysis of neonatal community-acquired pneumonia pathogens

目的了解新生儿社区获得性肺炎病原体分布及药敏状况。方法选择2015年10月~2016年10月收住我院新生儿科的新生儿社区获得性肺炎患儿225例,取下呼吸道深处分泌物,检测病原体并进行药敏分析。结果225份呼吸道分泌物标本共检出病原微生物152株,细菌117株,其中G^+菌40株,G^-菌77株;病毒23株,支原体12株;最常见的G^-菌为肺炎克雷伯菌,G^+菌为金黄色葡萄球菌,病毒以呼吸道合胞病毒为主。第三代头孢菌素对治疗革兰阴性菌感染敏感性较高;第一、二代头孢菌素治疗效果较差。青霉素治疗革兰阳性菌感染效果较差;亚胺培南、万古霉素仍然是敏感性最高的药物。低体重及早期新生儿混合感染率较正常体重儿及晚期新生儿偏高(P均<0.05)。结论 G^-菌是本地区新生儿社区获得性肺炎的主要病原体,肺炎克雷伯菌和金黄色葡萄球菌分别为主要病原菌,耐药性分析能有效指导临床用药,提高抗生素的合理使用及疗效。

Objective To investigate the distribution and drug susceptibility status in neonatal community-acquired pneumonia pathogens. Methods A total of 225 children with neonatal community-acquired pneumonia in the Department of Neonatology of our hospital from October 2015 to October 2016 were enrolled. The secretions of the lower respiratory tract were taken. The pathogens were examined and analyzed for drug susceptibility analysis. Results 152 strains of pathogenic microorganisms were detected in 225 samples of respiratory secretions. There were 117 Strains of bacteria, of which 40 strains were G^＋ bacteria and 77 strains were G^- bacteria. And there were 23 strains of viruses and 12 strains of mycoplasma. The most common G^- bacterium was Klebsiella pneumonia, and the most common G^＋ bacterium was Staphylococcus aureu. The virus was mainly respiratory syncytial virus. The third-generation cephalosporins were more sensitive to the treatment of Gram-negative bacterial infections,and the first and second-generation cephalosporins were less effective. Penicillin treatment of Gram-positive bacteria infection was poor, while Imipenem; Vancomycin were still the most sensitive drugs. The mixed infection rate of low body weight and early newborns was higher than those of normal weight and advanced newborns（P〈0.05）. Conclusion G^- bacteria is the main pathogen of neonatal community-acquired pneumonia in the community. Klebsiella pneumoniae and Staphylococcus aureus are the main pathogens. Drug resistance analysis can effectively guide clinical medicine and improve the rational use and efficacy of antibiotics.