新生儿凝固酶阴性葡萄球菌血行感染类型及耐药性  

Hematogenous infection type of neonatal coagulase negative staphylococcus and its drug resistance

作　　者：陈益明[1] 韦云龙[1] 曹春来[1] 徐立冬[1] 林峰[1] 

机构地区：[1]浙江省杭州市余杭区妇幼保健院,杭州311100

出　　处：《中国卫生检验杂志》2011年第1期130-132,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:了解新生儿凝固酶阴性葡萄球菌血行感染类型及耐药性情况,为临床合理用药提供依据。方法:回顾分析2006年1月-2009年12月,本院新生儿室送检的3390例血培养及体外抗生素药敏试验结果。血培养使用Bact/A-LERT 3D(120)全自动血培养系统及其配套的培养瓶,病原菌鉴定及药敏试验采用法国B iom erieux公司的API细菌鉴定系统及配套试剂。结果:在3390例新生儿血培养中,共检出416株病原菌(12.3%),主要以凝固酶阴性葡萄球菌(CNS)为主,占74.0%(308/416),耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为85.4%,CNS中以表皮葡萄球菌、溶血葡萄球菌、路邓葡萄球菌、头状葡萄球菌为主,其MRS的检出率分别为:84.6%、100.0%、81.8%、90.9%。在溶血葡萄球菌中,MRS的检出率4年间没有发生变化均为100.0%。耐甲氧西林表皮葡萄球菌(MRSE)、甲氧西林敏感表皮葡萄球菌(MSSE)和其它CNS对万古霉素、喹奴普汀/达福普汀、呋喃妥因、米诺霉素、利福平、替考拉宁、呋西地酸的耐药率均较低,差异没有统计学意义(P>0.05)。结论:CNS为本地区新生儿败血症的主要病原菌,其耐药情况严重,MRCNS的高检出率给临床治疗和控制医院感染带来困难,糖肽类抗菌药物可作为多重耐药CNS重症感染的首选药物。Objective：To investigate the hematogenous infection type of neonatal coagulase negative staphylococcus and its drug resistance to provide clinical guidance of rational administration.Methods： From January 2006 to December 2009,3 390 cases of blood cultures and in vitro antibiotic susceptibility test results were analyzed retrospectively.Blood cultures were detected by Bact/where 3D（120） automatic blood culture system and the related culture flask.The pathogens identification and the susceptibility test were performed through France Biomerieux company API bacteria identification system and its supporting the reagent bar.Results： There were 416 strains pathogenic bacteriacases in the 3 390 neonatal blood cultures with the rate of（12.3%）,among which.coagulase negative staphylococcus（CNS） were the most with the rate of 74.0%（308/416）.The detection rate of methicillin resistant coagulase negative staphylococcus（MRCNS） was 85.4% in CNS,and the main pathogenic bacterium were staphylococcus epidermidis,staphylococcus haemolyticus,staphylococcus lugdunensis,staphylococcus capitis,with rate of 84.6%,100.0%,81.8%,90.9% one by one.The detection rate of MRS was always 100.0% never changed among staphylococcus haemolyticus in four yeas.Methicillin resistant staphylococcus epidermidis（MRSE）,methicillin sensitive staphylococcus epidermidis（MSSE） and other CNS all had low drug resistant rate to vancomycin,quinupristin-dalfopristin,furadantin,klinomycin,rifampin,teicoplanin and fusidic acid,and their difference had no statistically significance（P0.05）.Conclusion： CNS was the main pathogenic bacterium causing neonatal septicemia in our region,and the drug resistant condition was very serious.The high detection rate of MRCNS took much difficulty to clinical treatment and hospital infection′s control.The glycopeptides antibacterials may be the choice drug to severe infection of multidrug resistant CNS.

关 键 词：新生儿败血症 凝固酶阴性葡萄球菌 血行感染 耐药性 

分 类 号：R722.131[医药卫生—儿科]