长春地区新生儿败血症病原学分布及耐药性分析

Etiology Distribution and Drug Resistance of Neonatal Sepsis in Changchun

目的:分析长春地区新生儿败血症的临床表现、病原学分布及耐药性情况,为临床医师合理用药提供参考。方法:以长春儿童医院2017年1月-2019年12月47例血培养阳性的新生儿败血症患儿为研究对象,对其血培养结果及药敏试验进行分析。结果:47例新生儿败血症患儿以发热、黄疸、肺部感染多见。革兰阳性菌33株(70.21%),主要是凝固酶阴性葡萄球菌,其对青霉素类及大环内脂类普遍耐药,对头孢菌素类耐药性达50%以上;金黄色葡萄球菌对青霉素类、大环内酯类耐药性达50%以上,对头孢菌素类相对敏感;二者均未见对替考拉宁、万古霉素、利奈唑胺、亚胺培南、美罗培南耐药菌株。革兰阴性菌12株(25.53%),主要致病菌有大肠埃希菌和肺炎克雷伯杆菌,二者对氨苄西林耐药率分别为40%和50%,大肠埃希菌对头孢菌素类敏感,肺炎克雷伯杆菌对头孢菌素类部分耐药,二者均未见对亚胺培南、美罗培南耐药菌株。结论:长春地区新生儿败血症的病原菌主要为革兰阳性菌,主要是凝固酶阴性葡萄球菌;其次为革兰阴性菌,主要是大肠埃希菌、肺炎克雷伯杆菌;在临床用药过程中,应考虑当地常见病原菌及常见细菌耐药的情况,针对性地选择治疗,从而提升治疗效果。

Objective:To analyze the clinical manifestations,etiology distribution and drug resistance of neonatal sepsis in Changchun,so as to provide a reference for clinicians in rational drug use.Method:A total of 47 cases of neonatal sepsis with positive blood culture from January 2017 to December 2019 in Changchun Children's Hospital were selected as the research objects.The results of blood culture and drug sensitivity test were analyzed.Result:Fever,jaundice and pulmonary infection were common in 47 cases of neonatal sepsis.There were 33 gram-positive bacteria(70.21%),mainly coagulase negative staphylococcus,which were generally resistant to penicillins and macrolides,and more than 50%of them were resistant to cephalosporins.Staphylococcus aureus was more than 50%resistant to penicillins and macrolides,but relatively sensitive to cephalosporins.No drug-resistant strains of Teicoplanin,Vancomycin,Linezolid,Imipenem and Meropenem were found in either.There were 12 gram-negative bacteria(25.53%),the main pathogenic bacteria were escherichia coli and klebsiella pneumoniae.The drug resistance rates of Ampicillin were 40%and 50%,respectively.Escherichia coli was sensitive to cephalosporins.Klebsiella pneumoniae was partially resistant to cephalosporins.No Imipenem and Meropenem resistant strains were found in either.Conclusion:The main pathogenic bacteria of neonatal sepsis in Changchun were gram-positive bacteria,mainly coagulase negative staphylococcus.Gram-negative bacteria followed,mainly Escherichia coli and Klebsiella pneumoniae.In the process of clinical medication,we should consider the local common pathogenic bacteria and common bacterial resistance,targeted treatment,so as to improve the treatment effect.