新生儿血液细菌培养结果及耐药性  

Neonatal blood culture results and drug resistance

作　　者：陈益明[1] 韦云龙[1] 曹春来[1] 徐立冬[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3期678-680,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:了解本地区新生儿患者血液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/ALERT 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Biomerieux公司的API细菌鉴定系统及配套试剂条。结果:在3390例新生儿血培养中,细菌培养阳性416例,阳性率为12.3%。革兰阳性菌有402株占96.6%,革兰阴性菌有14株占3.4%。检出最多的病原菌是凝固酶阴性葡萄球菌(CNS),其次是肠球菌、金黄色葡萄球菌、大肠埃希菌,未发现B组溶血性链球菌(GBS)。其中甲氧西林耐药的凝固酶阴性葡萄球菌(MRCNS)247株检出率为80.2%(247/308),甲氧西林耐药的金黄色葡萄球菌(MRSA)21株检出率为72.4%(21/29),两者无统计学差异(χ2=0.363,P=0.547)。MRCNS的耐药状况比MRSA严重,未发现对万古霉素耐药的葡萄球菌和肠球菌,大肠埃希菌、肺炎克雷伯菌对亚胺培南均敏感。结论:CNS为本地区新生儿败血症的主要病原菌,进一步加强对新生儿患者血培养检测及其耐药性分析,是临床诊治新生儿败血症的重要手段。Objective：To investigate the region neonatal blood infection type and the drug resistance to provide clinical guidance of antibiotic usage.Methods：From January 2006 to December 2009,3390 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：In the 3390 neonatal blood cultures,there were 416 cases of germiculture positive（12.3%）,among which 402 strains were Gram-positive with the rate of 96.6%,and 14 strains were gram-negative with the rate of 3.4%.The coagulase-negative staphylococcus aureus（CNS） was the most in the pathogens detected,the second was enterococcus,staphylococcus aureus,escherichia coli,however the group B hemolytic streptococcus（GBS） had not found.There were 247 strains of methicillin resistant coagulase negative staphylococcus（MRCNS） with the rate of 85.7%（247/308）,21 strains of methicillin resistant staphylococcus aureu（MRSA） with the rate of 72.4%（21/29）,but the two had no statistically significant differences（χ2=0.363,P=0.547）.MRCNS drug-resistance was more serious than MRSA.Vancomycin resistance of staphylococcus and enterococcus were not found.The escherichia coli and pneumonia crayresearch strains were sensitive to imipenem.Conclusion：CNS was the main pathogen causing neonatal septicemia in our region,and to further strengthen the neonatal blood culture detection and drug resistance analysis was an important clinical means of neonatal sepsis diagnosis and treatment.

关 键 词：新生儿 血液培养 耐药性 凝固酶阴性葡萄球菌 金黄色葡萄球菌 

分 类 号：R722.131[医药卫生—儿科]