549例新生儿肺炎的病原菌分布及耐药性分析  

Distribution and Antibiotic Resistance of Pathogens from 549 Neonates with Pneumonia

作　　者：钟世民[1] 陈盛[1] 何念海[1] 胡影[1] 沈蕾蕾[1] 

机构地区：[1]第三军医大学西南医院,重庆400038

出　　处：《儿科药学杂志》2013年第5期32-36,共5页Journal of Pediatric Pharmacy

摘　　要：目的:探讨新生儿肺炎病原菌的分布特点和耐药特征,指导临床合理用药。方法:收集549例新生儿肺炎的痰标本,进行病原学分离、鉴定和药物敏感试验,并对G-杆菌进行ESBLs的检测。结果:共309例痰标本分离出病原茵,总阳性率为56.3%;G-杆菌与G+菌之比约为3∶1;金黄色葡萄球菌对青霉素、红霉素耐药率均>75%,对米诺环素、氯霉素、万古霉素、替考拉宁和利奈唑烷敏感。产ESBLs的G-杆菌的检出率为21.6%;产ESBLs的肺炎克雷伯菌和大肠埃希菌对氨曲南、氨苄西林、头孢噻肟、头孢唑林、哌拉西林、庆大霉素耐药率高;阴沟肠杆菌对阿米卡星、头孢吡肟、左氧氟沙星、庆大霉素、奈替米星、亚胺培南耐药率低;鲍曼不动杆菌对氨曲南、氨苄西林、头孢唑林、哌拉西林耐药率较高,对亚胺培南最敏感;流感嗜血杆菌对头孢唑林耐药率高,对亚胺培南、头孢他啶、哌拉西林/他唑巴坦、头孢吡肟、头孢噻肟敏感。结论:G-杆菌为新生儿肺炎感染的主要病原菌;细菌耐药性日趋严重,应引起重视,合理选择有效抗菌药物对治疗新生儿肺炎具有重要的意义。Objective： To study the clinical distribution and drug resistance characteristics of pathogens causing neonatal pneumonia, and to provide the guide for clinical therapy. Methods： Sputum specimen were gathered from 549 neonates with pneumonia. Pathogens isolation and identification, drug resistance tests were performed. ESBLs-producing G-bacilli were also detected. Results： Pathogens were found from 309 sputum specimen （56.3%）. The ratio between gram-negative bacilli and gram-positive coccus was 3 ： 1. Drug resistance results showed that the resistance rates of Staphylococcus aureus to penicillin and erythromycin were more than 75%. Staphylococcus aureus was sensitive to minocycline, chloromycetin, vancomycin, teicoplanin and linezolid. 21.6% gram-negative bacilli produced ESBLs. ESBLs-producing Klebsiella pneumoniae and Escherichia coli were highly resistant to aztreonam, ampicillin, cefotaxime, cefazolin, piperacillin and gentamicin. The resistance rates of Enterobacter cloacae to amikacin, cefepime, levofloxacin, gentamicin, netilmicin and imipenem were low; Acinetobacter baumannii had high resistance rates to aztreonam, ampicillin, cefazolin and piperacillin, while it was the most sensitive to imipenem; Haemophilus influenzae had high rate of resistance to cefazolin, but was sensitive to ceftazidime, imipenem piperacillin/tazobactam, cefepime, and cefotaxime. Conclusions： The gram-negative bacteria were the main pathogens causing neonatal pneumonia; bacterial resistance is becoming more and more serious. Selecting antimicrobial agents rationally is important to treated neonatal pneumonia.

关 键 词：新生儿 肺炎 病原菌 耐药性 药敏试验 

分 类 号：R969.3[医药卫生—药理学] R722.1[医药卫生—药学]