某三甲医院新生儿重症监护室多重耐药菌分布及耐药性分析

Analysis of Distribution and Drug Resistance of Multi-Drug Resistant Bacteria in Neonatal Intensive Care Unit in a Tertiary Hospital

目的研究新生儿重症监护室多重耐药菌分布与耐药情况,为感染控制的防治提供参考。方法采用WHONET5.6软件分析2018—2022年医院新生儿重症监护室多重耐药菌标本来源、感染分布及耐药情况。结果检出多重耐药菌214株,其中Kpn(ESBLs+)71株,MRSA57株,E.coli(ESBLs+)46株,MDR-PA 23株;痰液标本76株,以Kpn(ESBLs+)31株居首;血液标本74株,以Kpn(ESBLs+)26株、MRSA20株较多;分泌物标本41株,以E.coil(ESBLs+)18株较多;Kpn(ESBLs+)、E.coli(ESBLs+)、MDR-PA对氨苄西林耐药严重,对二代、三代头孢普遍耐药,对亚胺培南、美罗培南、阿米卡星、环丙沙星、左氧氟沙星敏感;MRSA对氨苄西林、青霉素、苯唑西林、克林霉素、红霉素耐药严重,对万古霉素、替加环素、利奈唑胺敏感。结论新生儿重症监护室多重耐药菌的定期监测对于合理用药具有重要临床意义。

Objective To study the distribution and drug resistance of multi-drug resistant bacteria in neonatal intensive care unit,and provide reference for infection control and prevention.Methods WHONET5.6 software was used to analyze the source,infection distribution,and drug resistance of multi-drug resistant bacteria in neonatal intensive care unit of hospital from 2018 to 2022.Results 214 multidrug-resistant strains were detected,including 71 Kpn(ESBLs+),57 MRSA,46 E.coli(ESBLs+)and 23 MDR-PA strains.76 strains of sputum were collected,31 of which were Kpn(ESBLs+).There were 74 strains in blood samples,including 26 Kpn(ESBLs+)and 20 MRSA.There were 41 secretions,18 of which were E.coil(ESBLs+).Kpn(ESBLs+),E.coli(ESBLs+)and MDR-PA were seriously resistant to ampicillin,generally resistant to the second and third generation of cephalosporin,and sensitive to imipenem,meropenem,amicacin,ciprofloxacin and levofloxacin.MRSA was highly resistant to ampicillin,penicillin,oxacillin,clindamycin and erythromycin,and was sensitive to vancomycin,tigacycline and linezolid.Conclusion Regular monitoring of multi-drug resistant bacteria in NICU is of great clinical significance for rational drug use.