13例新生儿医院感染肺炎克雷伯菌败血症药敏及临床分析  

An Analysis of Clinical Features and Drug Sensitivity of 13 Neonatal Septicemia with Nosocomial Klebsiella Pneumoniate

作　　者：李志玲[1] 石玉萍[1] 宋丹妮[1] 江虹[1] 樊丹怡[1] 沈嘉茵[1] 何珊[1] 常宏[1] 

机构地区：[1]广东省深圳市妇幼保健院,广东深圳518028

出　　处：《儿科药学杂志》2010年第4期37-39,共3页Journal of Pediatric Pharmacy

摘　　要：目的:探讨院内感染新生儿肺炎克雷伯菌败血症的临床特征和药敏情况,为临床合理防治提供依据。方法:回顾分析我院新生儿科2006年4月至2009年5月间13例确诊为院内感染的肺炎克雷伯菌败血症患儿的临床资料、细菌药敏试验结果。结果:早产、极低出生体重、使用广谱抗生素、侵入性操作多、住院时间长为肺炎克雷伯菌败血症的易感因素。13株肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)的菌株有10株(76.9%),对青霉素、头孢菌素类几乎全部耐药(敏感率为7.6%),对含酶抑制剂类药物、喹诺酮和氨基苷类抗生素敏感率较高(53.8%～100%);对亚胺培南、美罗培南敏感高(96.2%)。结论:新生儿科患儿普遍存在院内感染肺炎克雷伯菌败血症的易感因素。此类细菌绝大部分为产ESBLs菌株,亚胺培南、美罗培南为其首选药物。Objective：To explore the clinical characteristics and the drug sensitivity of neonatal septicemia with nosocomial Klebsiella pneumoniate so as to provide evidences for prevention and treatment of the disease.Methods：A retrospective analysis on the clinical characteristics and drug sensitivity of all the 13 cases confirmed as nosocomial neonatal septicemia with Klebsiella pneumoniate in our hospital from April,2006 to May,2009 was performaed.Results：The risk factors of nosocomial Klebsiella pneumoniate septicemia were prematurity,extremely low birth weight,use of broad-spectrum antibiotics,too much virulence operation and long length of hospital stay.There were 10 strains（76.9%）producing extended spectrum β-lactamases（ESBLs）among the 13 strains.Almost all of the Klebsiella pneumoniate strains were resistant to penicillin and cephalosporins（the sensitive rate was 7.6%）,but sensitive to those containing enzyme inhibitors,quinolones and aminoglycosides（53.8%~100%）,and more sensitive to imipenem（96.2%）and meropenem（100.0%）.Conclusions：There are predisposing factors in newborn infants to nosocomial Klebsiella pneumoniate septicemia and the strains of Klebsiella pneumoniate almost produce ESBLs,therefore imipenem or meropenem is the best choice.

关 键 词：新生儿 克雷伯菌 肺炎 败血症 超广谱Β-内酰胺酶 抗生素 

分 类 号：R725.622.1[医药卫生—儿科]