新生儿下呼吸道感染病原菌种类及药敏分析

Species of pathogens causing nosocomial neonatal respiratory tract infection and antimicrobial susceptibility analysis

目的 探讨新生儿下呼吸道感染病原菌的种类及主要病原菌的耐药特点 ,以指导临床预防和合理用药。方法 对某院 2 0 0 0年 1月～ 2 0 0 2年 6月间 79份新生儿下呼吸道分泌物标本进行细菌培养及药敏分析。结果 79份标本中有 6 8份培养阳性 ,阳性率为 86 .0 8% ;共检出病原菌 74株 ,6 1株 (82 .4 3% )为革兰阴性 (G-)杆菌 ,其中大肠埃希菌 2 6株 (35 .1 4 % )、肺炎克雷伯菌 1 3株 (1 7.5 7% )、鲍曼不动杆菌 1 1株 (1 4 .86 % )、肠杆菌属 1 0株(1 3.5 1 % )。大肠埃希菌和肺炎克雷伯菌产超广谱β 内酰胺酶菌株分别占88.4 6 %和 6 9.2 3% ,耐药率高 ,且表现为多重耐药。未发现对亚胺培南和美罗培南耐药的菌株 ,阿米卡星、头孢吡肟、头孢他啶的耐药率也较低。结论 G-杆菌是新生儿呼吸道感染的重要病原菌 ,耐药率高 。

Objective To study the species and antimicrobial resistance of pathogens causing nosocomial neonatal respiratory tract infection, and provide guidance for the rational use of antimicrobial agents. Methods Bacterial culture and antimicrobial susceptibility tests were done on 79 samples from neonatal lower respiratory tracts from January 2000 to June 2002. Results The bacteria were isolated in 68 of 79 (86.08%) samples and 74 pathogenic strains were identified, 61 (82.43%) of which were Gram negative bacilli; 26 (35.14%) of which were Escherichia coli, 13 (17.57%) were Klebsiella pneumonia, 11 (14.86%) were Acinetobacter baumannii, 10 (13.51%) were Enterobacter. 88.46% of Escherichia coli and 69.23% of Klebsiella pneumonia were extended spectrum β lactamase producing strains which had multiply antimicrobial resistance. All strains were sensitive to imipenem and meropenem, the resistance to amikacin, cefepime and ceftazidime were also low. Conclusion Gram negative bacilli are the main pathogens causing neonatal respiratory tract infection, which have high resistance to antimicrobial agents.