凉山州西昌地区新生儿大肠埃希菌败血症临床表现及耐药性分析

Analysis of clinical manifestations and drug resistance of neonatal Escherichia coli septicemia in Xichang area,Liangshan prefecture

目的分析凉山州西昌地区新生儿大肠埃希菌败血症临床表现及大肠埃希菌对抗菌药物的耐药情况。方法对2013年3月-2018年3月该院收治的新生儿败血症患儿的血标本进行培养、分离、鉴定,分析血培养病原菌为大肠埃希菌患儿的临床表现及大肠埃希菌耐药情况。结果新生儿大肠埃希菌败血症临床表现与其他病原菌败血症临床表现无差异。大肠埃希菌对哌拉西林、氨苄西林耐药率>60%,有较高耐药性;对环丙沙星、左氧氟沙星、庆大霉素耐药率30%左右;对头孢噻肟、头孢曲松、头孢呋辛、头孢唑啉等耐药率20%左右;对头孢西丁耐药率仅5.6%;对β-内酰胺酶抑制剂复方制剂(阿莫西林克拉维酸钾、哌拉西林他唑巴坦)、碳青霉烯类(美罗培南)均无耐药。结论凉山州西昌地区新生儿大肠埃希菌败血症临床表现无特异性。该地区大肠埃希菌耐药率较高,对β-内酰胺酶抑制剂复方制剂敏感,可作为一线经验性用药。

Objective To analyze the clinical manifestations of neonatal Escherichia coli septicemia in Xichang area of Liangshan prefecture and the drug resistance of pathogenic bacteria.Methods Blood samples from children with neonatal sepsis admitted to the hospital from March 2013 to March 2018 were cultured,isolated,and identified,the clinical manifestations of pathogenic bacteria isolated from blood culture of neonatal septicemia and the drug resistance of the pathogen were analyzed retrospectively.Results The clinical manifestations of neonatal coliform septicemia were the same as those of other pathogenic bacteria pneumonia.The resistance rate of Escherichia coli to piperacillin and ampicillin was more than 60%;The resistance rates of ciprofloxacin,levofloxacin,gentamicin were about 30%;The resistance rates of cefotaxime,ceftriaxone,cefuroxime,cefazolin were about 20%;The resistance rates of cefoxitin were 5.6%;At present,the strain was not resistant to compoundedβ-lactamase inhibitor(amoxicillin-clavulanate potassium,piperacillin-tazobactam)or carbapenem(meropenem).Conclusion Clinical manifestation of neonatal Escherichia coli septicemia in Xichang area,Liangshan prefecture is the same as those of other pathogenic bacteria.The drug resistance of Escherichia coli in the area is relativelly higher but the strain is still sensitive to compoundedβ-lactamase inhibitor,therefore compoundedβ-lactamase inhibitor may be used as a first-line empirical treatment.