198例新生儿败血症病原学与耐药性分析

Distribution and drug resistance of pathogens isolated from 198 neonates with septicemia

目的了解医院新生儿败血症菌群分布和细菌耐药情况,为临床医生合理使用抗菌药物提供参考依据。方法回顾性分析2014年1月-2016年12月医院分娩时诊断为败血症,且血培养阳性的198例新生儿的基本资料和血培养结果进行统计分析;采用x2检验分析不同组别之间的临床基本特征差异。结果医院198例新生儿败血症的血液标本培养分离出病原菌263株,其中革兰阳性菌228株,占86.7%,且以凝固酶阴性葡萄球菌(MRCNS)为主,其对青霉素G、红霉素、克林霉素、磺胺甲噁唑/甲氧苄啶有较高的耐药性;革兰阴性菌检出19株,占7.2%,对亚胺培南、阿米卡星的耐药率较低;真菌检出16株,占6.1%,仅一株耐药菌。结论在新生儿败血症的治疗过程中,要特别注意凝固酶阴性葡萄球菌引起的败血症,定期对医院常见病原菌耐药性进行分析,根据其药敏情况合理地选择抗菌药物。

OBJECTIVE To explore the distribution and drug resistance of pathogens isolated from neonates with septicemia so as to provide guidance for reasonable clinical use of antibiotics.METHODS From Jan 2014 to Dec2016,the baseline data of 198 neonates who were diagnosed with septicemia during childbirth and were positive for blood culture were retrospectively analyzed,the result of blood culture was statistically analyzed,and the clinical essential characteristics were compared by means of chi-square test.RESULTS A total of 263 strains of pathogens were isolated from blood specimens of the 198 neonates with septicemia,of which 228（86.7%）were gram-positive bacteria,19（7.2%）were gram-negative bacteria,and 16（6.1%）were fungi.The coagulase-negative Staphylococcus was dominant among the gram-positive bacteria and was highly resistant to penicillin G,erythromycin,clindamycin,and sulfamethoxazole-trimethoprim;the drug resistance rates of the gram-negative bacteria to imipenem and amikacin were relatively low;only one strain of fungi was drug-resistant.CONCLUSIONIt is necessary to pay special attention to the septicemia induced by the coagulase-negative Staphylococcus during the treatment of the neonates with septicemia,regularly analyze the drug resistance of the common species of pathogens,and reasonably use antibiotics based on the result of the drug susceptibility testing.