早产与足月新生儿早发型败血症病原菌及药敏对比分析

Comparative analysis of pathogenic bacteria in preterms and full-term newborns with early onset sepsis

目的分析早产与足月新生儿早发型败血症(EOS)病原菌及药物敏感性(药敏)的差异。方法采用回顾性分析,将2020年1—12月重庆医科大学附属儿童医院新生儿科住院诊断为EOS的250例新生儿作为研究对象,其中早产儿96例(早产组),足月新生儿154例(足月组)。分析两组患儿病原菌分布及药敏情况。结果早产组患儿呼吸衰竭、肺出血等并发症发生率均明显高于足月组,差异均有统计学意义(P<0.05)。早产组患儿革兰阴性(G^(-))菌感染占75.0%(72/96),革兰阳性(G^(+))菌占25.0%(24/96),足月组患儿G^(-)菌、G^(+)菌感染分别占55.8%(86/154)及44.2%(68/154)。两组患儿G^(-)菌构成均以大肠埃希菌、肺炎克雷伯菌为主,G^(+)菌构成均以表皮葡萄球菌、溶血葡萄球菌为主。早产组患儿产超广谱β-内酰胺酶细菌比例明显高于足月组,差异有统计学意义(P<0.05)。G^(-)菌对碳青霉烯类(90.1%~91.4%)、氨基糖苷类(74.4%~97.0%)、喹诺酮类(83.3%~89.7%)保持高敏感性。G^(+)菌对万古霉素等多肽类抗生素、噁唑烷酮类抗生素保持100%敏感性。两组患儿病原菌对大部分抗G^(+)菌抗生素敏感性比较,差异无统计学意义(P>0.05)。结论早产与足月儿EOS病原菌有差异,其药敏情况相似。

Objective To analyze the differences of pathogens and drug sensitivities between preterms and full-term newborns with early-onset sepsis(EOS).Methods The retrospective analysis was adopted.A total of 250 hospitalized newborns with EOS in the neonatology department of the Affiliated Children’s Hospital of Chongqing Medical University served as the study subjects,including 96 preterms(preterm group)and 154 full term newborns(full term group).The pathogenic bacterial distribution and drug sensitivities in the two groups were analyzed.Results The incidence rates of complications such as respiratory failure and empsyxis in the preterm group were significantly higher than those in the full-term group(P<0.05).Gram-negative bacterial(G^(-))infection and Gram-positive bacterial(G^(+))infection in the preterm group accounted for 75.0%(72/96)and 25.0%(24/96)respectively,and which in the full term group accounted for 55.84%(86/154)and 44.16%(68/154)respectively.In two groups,the G^(-) bacterial composition were mainly Escherichia coli and Klebsiella pneumoniae,meanwhile the G^(+) bacteria were mainly Staphylococcus epidermidis and Staphylococcus haemolyticus.The proportion of ESBLs producing bacteria in the preterm group was significantly higher than that in the full term group,and the difference was statistically significant(P<0.05).G^(-) bacteria were highly sensitive to carbapenems(90.1%-91.4%),aminoglycosides(74.4%-97%)and quinolones(83.3%-89.7%).G^(+) bacteria were highly sensitive to vancomycin and oxazolidines(100.0%).The pathogenic bacteria in the two groups were more sensitive to most of anti-G^(+) bacterial antibiotics,and the difference was not statistically significant(P>0.05).Conclusion The pathogenic bacteria of EOS are differences between preterm and term infants,and their drug sensitivity is similar.