新生儿脐部感染的病原菌分布及耐药性分析

Analysis of distribution and drug resistance of pathogenic bacteria of neonatal umbilical infection

目的:了解新生儿脐部感染的病原菌分布及药物敏感情况,为临床合理应用抗生素提供参考。方法:对本院2014年3月—2017年10月住院新生儿脐部分泌物培养出的病原菌种类及药敏结果进行回顾性分析。结果:共检出82株病原菌,革兰阳性菌占59.8%,主要为金黄色葡萄球菌和凝固酶阴性葡萄球菌;革兰阴性菌占39.0%,主要为大肠埃希菌和肺炎克雷伯菌。葡萄球菌对万古霉素、利奈唑胺、喹努普汀/达福普汀高度敏感且无耐药菌株,对青霉素、红霉素耐药性较高;大肠埃希菌和肺炎克雷伯菌对碳青霉烯类药物最为敏感,对青霉素类及头孢类抗生素有不同程度的耐药。结论:临床应高度重视新生儿脐部护理,对有感染迹象者可以先根据涂片结果经验性的选用抗生素治疗,同时进行细菌培养,并结合药敏结果及时调整用药,防止并发症的进一步发生。

Objective： To understand the distribution and drug sensitivity of pathogenic bacteria of neonatal umbilical infection, and to provide evidence for rational application of antibiotics in clinical practice. Methods： A retrospective analysis was conducted about the types of pathogens and the results of drug susceptibility of the umbilical secretions of neonates between March 2014 and October 2017 in aerospace center hospital. Results： 82 strains of pathogenic bacteria were detected, and among the 82 strains, Gram-positive bacteria accounted for 59.8%, which were mainly staphylococcus aureus and eoagulase-negative staphylococci. The second was Gram-negative bacteria, which accounted for 39.0%, with majority of eseheriehia coli and klebsiella pneumoniae. Staphylococci had no resistance to vaneomycin, linezolid and quinupeptin/dalfopristin, but had higher resistance to penicillin and erythromycin. Escherichia coli and klebsiella pneumoniae were the most sensitive to carbapenem and had some degrees of resistance to penicillins and cephalosporins. Conclusion： More attentions should be paid for neonatal umbilicus care. For neonates with signs of umbilicus infection, antibiotics could be selected experiment according to the result of smear. And in order to prevent further complications because of infection, bacteria culture should be conducted simultaneously, and then, antibiotic treatments should be adjusted timely according to antimicrobial sensitivity results.