90例细菌性感染新生儿碳青霉烯耐药的肠杆菌科细菌的分布特点及其耐药情况分析

Analysis of Distribution and Drug Resistance of 217 Strains of Carbapenem-resistant Enterobacteriaceae in Neonates

目的:探究新生儿碳青霉烯耐药的肠杆菌科细菌的分布特点及其药敏试验情况。方法:选取医院2018年3月—2020年6月儿科收治的细菌感染新生儿90例病历资料,统计其血、尿、痰、分泌物和其他标本中细菌培养、鉴定结果,分析其碳青霉烯耐药的肠杆菌科细菌的分布特点、医院感染情况,以及碳青霉烯耐药的肠杆菌科细菌对常用抗菌药物临床治疗的影响。结果:90例细菌感染新生儿各标本中,分离出217株肠杆菌科细菌,检出前5位病原菌分别是大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、奇异变形杆菌、产气肠杆菌;其中分离出碳青霉烯耐药的肠杆菌科细菌11株(大肠埃希菌1株、肺炎克雷伯菌6株、阴沟肠杆菌4株);耐碳青霉烯类细菌主要定植在新生儿肺炎、呼吸窘迫综合征、湿肺、败血症、高胆红素血症和其他临床感染疾病患者中,标本中分离出碳青霉烯耐药的肠杆菌科细菌主要来自血液、尿液、痰液、分泌物等标本;碳青霉烯耐药的肠杆菌科细菌耐药的药物主要是亚胺培南(100.00%)、氨苄西林(81.82%)、哌拉西林和美罗培南(72.73%)、氨曲南(63.64%)、哌拉西林与头孢他啶(54.55%)。结论:碳青霉烯耐药的肠杆菌科细菌在新生儿中的临床感染率较高,其中以大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌为主,其对多种抗菌药物耐药,而其对阿米卡星的敏感率较高。

Objective:To explore the distribution characteristics and drug resistance of carbapenam-resistant Enterobacteriaceae in neonates.Methods:The medical records of 90 neonates with bacterial infection admitted to the pediatrics department of our hospital from March 2018 to June 2020 were selected.The results of bacterial culture and identification in blood,urine,sputum,secretions and other samples were analyzed,and the distribution characteristics of carbapenem-resistant Enterobacteriaceae and the nosocomial infections were analyzed.The influence of carbapenem-resistant Enterobacteriaceae bacteria on the clinical treatment of common antibacterials was studied.Results:217 strains of Enterobacteriaceae were isolated from the samples of 90 neonates infected with bacteria.The TOP 5 pathogens were Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae,Proteus singular and Enterobacter aerogenes.In them,11 strains of carbapenem-resistant Enterobacteriaceae(1 strain of Escherichia coli,6 strains of Klebsiella pneumoniae and 4 strains of Enterobacter cloacae)were isolated.Carbapenem-resistant Enterobacteriaceae were mainly colonized in neonatal pneumonia,respiratory distress syndrome,wet lung,sepsis,hyperbilirubinemia and other clinical infections.Carbapenem-resistant Enterobacteriaceae were mainly isolated from blood,urine,sputum,secretions and other specimens.Carbapenem-resistant Enterobacteriaceae were mainly resistant to imipenem(100.00%),ampicillin(81.82%),piperacillin and meropenem(72.73%),aztreonam(63.64%),piperacillin and ceftazidime(54.55%).Conclusion:The clinical infection rate of carbapenem-resistant Enterobacteriaceae in neonates was high,in which the majority were Escherichia coli,Klebsiella pneumoniae and Enterobacter cloacae,which were resistant to a variety of antibacterial agents,but the sensitivity rate of amikacin was high.