新生儿败血症病原菌及药物敏感相关性分析及临床效果观察  

Analysis of pathogens and drug sensitivity test in neonatal septicemia and observation of clinical effect

作　　者：李金梅[1] 李英[1] 王城[2] 

机构地区：[1]川北医学院临床医学系 [2]川北医学院附属医院儿外科,四川南充637000

出　　处：《川北医学院学报》2012年第5期429-432,共4页Journal of North Sichuan Medical College

基　　金：川北医学院2011年学生科研基金项目(b-5)

摘　　要：目的:分析新生儿败血症血培养病原菌的构成及药物敏感性,观察用药方式与临床效果,指导临床合理应用抗生素。方法:对川东北地区207例新生儿败血症血培养阳性进行回顾性分析,用法国梅里埃VITEK-32全自动微生物测试仪对细菌进行鉴定和药敏试验,记录且统计病原菌的分布及药敏情况,同时观察用药方式导致的临床效果。结果:1 015例患儿血培养中,血培养阳性为207例,阳性率20.39%,菌种213株。G+球菌174株,占81.69%,其中凝固酶阴性葡萄球菌(coagu-lase negative staphylococcus,CNS)133株62.44%;G-杆菌27株(占12.68%)。G+球菌前3种细菌(表皮葡萄球菌,溶血葡萄球菌,金黄色葡萄球菌)对万古霉素的敏感率为100%;G-杆菌前2种细菌(肺炎克雷伯氏菌,大肠埃希菌),对亚胺培南的敏感率为100%。对于危重患儿的经验用药直接选用万古霉素、碳靑酶烯类药物临床效果更好。结论:引起新生儿败血症的细菌以G+球菌为主,CNS为主要病原菌,临床应根据血培养药敏结果选用有效抗生素,以减少耐药率的产生,提高疗效。但病情危重且未能及时得出血培养结果或无条件做血培养的患儿建议直接选用"顶级"抗生素(万古霉素或/和碳靑酶烯类药物)。Objective：To analyze the pathogenic bacteria and sensitivity test in neonatal septicemia and observe the mode of Medica- tion and clinical effect in order to instruct proper use of antibiotics. Methods ： The clinical data of 207 cases of neonatal septicemia from north and east of Sichuan province were analyzed restrospectively. Bacteria were identified and susceptibility test was performed using the VITEK-32 Auto-Microbic-system. Results：Of 1 015 blood sample,207 cases （20.39%） were sensitive in bacteria isolates,inclu- ding 213 bacteria strains. Gram-positive cocci（ 8 1. 69 % ）were predominated over gram-negative bacillus （12.68 ）, and coagulase nega- tive staphylococcus was the main pathogenic bacteria（62.44% ）. The first three pathogenic bacteria of gram-positive cocci were sensi- tive （100%）to vancomycin, and the first two gram-negative bacillus were sensitive （100%）to imipenem,it is better to use vancomycin or imipenem initial for children with serious disease. Conclusion：Gram-positive cocci is main pathogen in neonatal septicemia, as coag- ulase negative staphylococcus the most to choose sensitive antibiotics base on the drug sensitive test may decrease the occurrence of drug resistant to bacteria and increase the clinical curative effects,but when in critical condition,it is better to use vancomycin or imipenem initially.

关 键 词：新生儿败血症 药敏 临床效果 

分 类 号：R722.1[医药卫生—儿科]