新生儿病房阴沟肠杆菌感染及药敏结果分析  

Enterobacter cloacae infection and drug sensitivity analysis in neonatal department

作　　者：聂川[1] 张永[1] 罗先琼[1] 赵长安[1] 杨杰[1] 张春一[1] 

机构地区：[1]广东省妇幼保健院新生儿科,广东广州510010

出　　处：《临床儿科杂志》2011年第9期825-828,共4页Journal of Clinical Pediatrics

基　　金：广东省科技计划资助项目(No.2007B031500009)

摘　　要：目的回顾性分析新生儿病房阴沟肠杆菌感染情况及药敏结果,为有效防治阴沟肠杆菌感染提供依据。方法对2008年2—7月新生儿病房送检的血、痰、尿、大便、脑脊液及脐带分泌物等细菌培养阳性标本进行分析,并采用K-B纸片扩散法检测药物敏感性,通过改良酶提取物头孢西丁和头孢曲松三维试验检测AmpCβ2内酰胺酶(AmpC酶)和产超广谱β2内酰胺酶(ESBLs),分析不同种类阴沟肠杆菌的药敏结果。结果院内感染47例,占所有病例的7.4%,所有标本中共检出各类细菌395株,肺炎克雷伯细菌、大肠埃希菌及金黄色葡萄球菌位列前3位(分别占43.2%,10.6%和8.6%),阴沟肠杆菌14株(3.54%),排第8位。标本来源为痰液、血液、尿液和脐带分泌物,分别占64.2%、14.3%、14.3%和7.14%;单产AmpC酶、产AmpC酶+ESBLs、单产ESBLs的检出率分别为21.4%、14.2%、14.2%;产酶株的耐药性明显高于非产酶株,全部菌株对亚胺培南敏感。结论阴沟肠杆菌在新生儿病房感染中并非常见细菌,其主要引起呼吸道、血液、尿路和脐部感染,产AmpC酶和ESBLs在阴沟肠杆菌中较为常见,在未明确药敏之前,可考虑将亚胺培南列为经验用药,及早有效治疗新生儿阴沟肠杆菌院内感染。Objective To analyze retrospectively the infection of Enterobacter cloacae in neonatal department and its related drug sensitivity in six months from February to July in the year of 2008,to offer evidence to prevent and cure Enterobacter cloacae infection effectively.Methods To collect the general information of Enterobacter cloacae infection,the specimens positive for Enterobacter cloacae were studied,such as blood,sputum,urine,stool,cerebrospinal fluid and umbilicus secretions,Meantime,drug sensitivity for the detected Enterobacter cloacae strains was tested by disk diffusion technique（K-B method）.Amp C β-lactamase and extended-spectrum β-lactamases（ESBLs） were analyzed by modified enzyme extract（cefoxitin and ceftriaxone）3-dimensional test.Results 47 cases（7.4%） of nosocomial infection were identified,and a total of 395 bacteria strains were cultured from studied specimens,the top three of which were Klebsiella pneumonia,Escherichia coli,and Staphylococcus aureus with the detection rate of 43.2%,10.6% and 8.6% respectively.However,the Enterobacter cloaca ranked eighth with 14 isolates and detection rate of 3.54%.The origins of Enterobacter cloacae were directly from sputum,blood,urine and umbilical secretions with the percentage of 64.2%,14.3%,14.3% and 7.14%,respectively.Meanwhile,the detection rates of Amp C β-lactamase producing strains and ESBLs producing strains were 21.4% and 14.2%,respectively,while the detection rate of the strains which could produce both Amp C β-lactamase and ESBLs accounts for 14.2% in our observation.The antibiotics resistance rate in β-lactamases producing strains was obviously higher than that in β-lactamases negative strains and all the strains sensitive to imipenem.Conclusions Enterobacter cloacae cannot be regarded as common bacteria causing infections in neonatal department.They often give rise to the infections of airway tract,blood,urine tract and umbilicus.It was found that Enterobacter cloacae producing AmpC enzyme or ESBLs are more common than other

关 键 词：新生儿 阴沟肠杆菌 感染 

分 类 号：R446.5[医药卫生—诊断学]