2018-2023年海南省儿童医院新生儿血流感染病原菌及其耐药性

Distribution and drug resistance of pathogens isolated from neonates with bloodstream infection in Hainan Children's Hospital from 2018 to 2023

目的探讨2018-2023年海南省儿童医院新生儿血流感染病原菌分布、耐药性及流行病学。方法法回顾性分析海南省儿童医院2018年1月-2023年5月血流感染的97例新生儿临床资料,统计不同胎龄新生儿血流感染病原菌构成情况,分析新生儿血流感染的主要病原菌在各年份分布和耐药情况。结果97例血流感染新生儿共检出病原菌112株,其中革兰阳菌较多(66株,占比58.93%)。新生儿血流感染病原菌在不同胎龄中有差异的分别为肺炎克雷伯菌、大肠埃希菌、白假丝酵母(P<0.05),主要病原菌(表皮葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌)在2018-2023年比较无统计学差异;表皮葡萄球菌对青霉素(94.23%)和红霉素(100.00%)耐药性较高,对万古霉素和呋喃妥因较敏感。肺炎克雷伯菌对头孢曲松(100.00%)和氨苄西林(100.00%)耐药性较高,对亚胺培南、美罗培南、阿米卡星较敏感。结论2018-2023年海南省儿童医院新生儿血流感染以革兰阳性菌感染居多,血流感染新生儿的病原菌在不同胎龄时的比较,发现有差异的致病菌包括肺炎克雷伯菌、大肠埃希菌、白假丝酵母。不同病原菌耐药性存在差异,对常用抗菌药物耐药性高。

OBJECTIVE To explore the distribution of pathogens,drug resistance and etiological characteristics of the neonates with bloodstream infections in Hainan Children's Hospital from 2018 to 2023.METHODS The clinical data were collected from 97 neonates with bloodstream infection who were treated in Hainan Children's Hospital from Jan 2018 to May 2023 and were retrospectively analyzed.The constituent ratios of the pathogens isolated from the different gestational age of neonates with bloodstream infection were statistically analyzed,and the distri-bution and drug resistance rates of the major species of pathogens isolated from the neonates with bloodstream in-fection in the years were analyzed.RESULTS Totally 112 strains of pathogens were isolated from the 97 neonates with bloodstream infection,66(58.93%)of which were gram-positive bacteria.Among the species of pathogens i-solated from the different gestational age of neonates with bloodstream infection,there were differences in Kleb-siella pneumoniae,Escherichia coli and Candida albicans(P<0.05).There were no significant differences in the major species of pathogens(Staphylococcus epidermidis,Staphylococcus aureus,K.pneumoniae,E.coli)be-tween 2018 and 2023.The drug resistance rate of the S.epidermidis strains to penicillin was 94.23%,erythromy cin 100.0o%,while the strains were sensitive to vancomycin and nitrofurantoin.The drug resistance rate of the K.pneumoniae strains to ceftriaxone was 100.00%,ampicillin 100.00%,while the strains were sensitive to imipenem,meropenem and amikacin.CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the neonates with bloodstream infection in Hainan Children's Hospital from 2018 to 2023.There are differences in K.pneumoniae,E.coli and C.albicans among the pathogens isolated from the different gestational age of neonates with bloodstream infection.There are significant differences in the drug resistance rates among the pathogens,and the strains are highly resistant to the commonly used antibiotics.