新生儿脐炎268例的病原菌及耐药性分析

Analysis of pathogenic bacteria and drug resistance of 268 cases of newborns with omphalitis

目的了解新生儿脐残端细菌性感染(脐炎)的病原菌以及耐药情况,为该病的防治提供参考。方法选取我院268例新生儿脐炎患儿,采集其脐部分泌物并行细菌培养,对分离得到的病原菌和耐药情况进行分析。结果 268例患儿中共分离到216株病原菌,包括金黄色葡萄球菌、凝固酶阴性葡萄球菌等革兰阳性菌株141株,占65.3%;大肠埃希菌、肺炎克雷伯菌等革兰阴性菌株75株,占34.7%。产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌以及大肠埃希菌亚种的比例较高。结论金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌以及大肠埃希菌等是新生儿脐炎的主要病原菌,且均具有较高耐药性,临床上应加强监测并选择合理药物对新生儿脐炎进行治疗。

Objective To understand the pathogenic bacteria of neonatal omphalitis and drug resistance so as to provide reference for the prevention and treatment of the disease. Methods Two hundred and sixty-eight cases of children with neonatal Omphalitis in our hospital were selected and their umbilical secretion was collected to carry out bacterial culture. The isolated pathogenic bacteria and its drug resistance were analyzed. Results Two hundred and sixteen strains of pathogenic bacteria were isolated from 268 cases,including 141 gram positive strains(Staphylococcus aureus and coagulase negative Staphylococcus),accounting for 65.3% and 75 gram negative strains(Escherichia coli) accounting for34.7%. The proportion of ESBLs producing Klebsiella pneumoniae and Escherichia coli subsp was higher. Conclusion Staphylococcus aureus,coagulase negative staphylococcus,Klebsiella pneumoniae and Escherichia coli are the main pathogenic bacterium in the treatment of neonatal omphalitis,and the above bacterium have high drug resistance. Clinical monitoring should be strengthened and the antibacterial drugs for treatment of neonatal omphalitis should be properly chosen.