同一地区不同医院新生儿科产超广谱β-内酰胺酶细菌感染的对比分析  

Clinical Characteristics and Drug Resistance of Extended-spectrum β-lactamases-producing Cells in Two Hospitals'Neonates of Same Region

作　　者：郑靖阳[1] 戴欢[2] 肖秀漫[2] 李昌崇[2] 

机构地区：[1]温州医学院附属定理临床学院(温州市中心医院)新生儿科,温州325000 [2]温州医学院附属第二医院育英儿童医院呼吸科

出　　处：《数理医药学杂志》2013年第4期431-433,共3页Journal of Mathematical Medicine

摘　　要：目的:了解同一地区不同医疗机构新生儿科产超广谱β-内酰胺酶(ESBLs)细菌感染的临床对比分析及耐药性分析,为临床治疗及预防提供依据。方法:回顾性分析同一地区不同医院(A院为三级甲等综合性医院,B院为三级甲等儿童专科医院)2010年1月～2011年12月新生儿科产超广谱β-内酰胺酶(ESBLs)细菌感染的情况及其药敏结果。结果:两所医院新生儿科产超广谱β-内酰胺酶(ESBLs)细菌感染率2011年高于2010年,B院感染率高于A院;肺炎克雷伯菌感染率超过大肠埃希菌;肺炎克雷伯菌以痰液检出率高,大肠埃希菌以血液检出占首位,药敏实验结果显示:(ESBLs)+肺炎克雷伯菌对头孢菌素类耐药率高(81.8%～100%),对青霉素+酶抑制剂耐药率也偏高(约70%),对氨基糖苷类、喹诺酮类、碳青霉烯类耐药率低(0～9.1%),对亚胺培南基本敏感,在B院发现4例耐药;产(ESBLs)+大肠埃希菌对亚胺培南普遍敏感,在B院发现2例耐药。结论:产超广谱β-内酰胺酶(ESBLs)细菌感染率逐年上升,其中B院稍高于A院;肺炎克雷伯菌感染率高于大肠埃希菌;对多种抗菌药物耐药,同一地区不同医院耐药性总体上相同,但是也存在一定差异,临床治疗应根据病原学检查及药物敏感试验合理选用抗菌药物。Objective： To investigate the clinical characteristics and drug resistance of extended-spectrum β-lactamases-producing cells in two hospitals＇ neonates of the same region and provide evidence for proper choose of antibiotics. Methods： The result of drug susceptibility and clinical characteristics of extended-spec- trum β- lactamases-producing cells from Jan 2010 to Dec 2011 were analyzed and studied retrospectively. Re- sults： The isolation rates of extended-spectrum β- lactamases-producing cells in 2011 is higher than 2010;The isolation rates of Klebsiella pneumoniae were the highest in the respiratory specimens, and escherichia coli were the highest in the blood. Klebsiella pneumoniae were not sensitive to penicillins and cephalosporins. Ex- tended-spectrum β- lactamases-producing cells were sensitive to imipenem. Conclusion： The infection rate of extended-spectrum B- lactamases-producing cells were more and more higher. In the same time, The infection rate of Klebsiella pneumoniae was higher than escherichia coll. It is similar with the drugr esistance in gener- al, however there are some differences in two hospital. Therefore, it is necessary to choose the antibiotics sensitive to extended-spectrum β- lactamases-producing cells according to the result of drug sensitive test.

关 键 词：超广谱β-内酰胺酶(ESBLs)细菌 大肠埃希菌 肺炎克雷伯菌 医院感染 耐药性 

分 类 号：R722.13[医药卫生—儿科]