新生儿社区获得性肺炎病原菌及临床用药分析  

Pathogenic bacteria and antibiotic application of neonatal community-acquired pneumonia

作　　者：羊玲 钟丽花[1] 林秋玉[1] 张娅琴[1] 黄育敏[2] 

机构地区：[1]海南省妇幼保健院新生儿科,海南海口570206 [2]海南省妇幼保健院检验科,海南海口570206

出　　处：《广州医学院学报》2013年第4期68-71,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨新生儿社区感染性肺炎(CAP)的病原菌分布、细菌耐药性及用药情况。方法:对2011年1月至2012年10月收治的126例新生儿CAP患儿行痰标本病原菌检测和药敏分析。结果:126例痰培养中,共检出92株(73.0%)致病菌。革兰阳性菌41株(44.6%),其中金黄色葡萄球菌29株(70.7%)最多见;革兰阴性菌51株(55.4%),其中肺炎克雷伯菌26株(51%)最多见。不同性别和白细胞水平患儿感染的病原菌比较,差异有统计学意义(P<0.05)。经验性单一用药、联合用药对革兰阴性菌和革兰阳性菌的有效率分别为56.5%、74.1%和45.0%、55.0%,两者比较,差异均无统计学意义(P>0.05)。结论:对新生儿CAP患儿,应积极进行病原学检测和药敏试验以指导临床合理用药。Objective： To investigate the distribution of pathogen, antibiotic resistance and application of antibiotics in neonates with community-acquired pneumonia （CAP）. Methods： We conducted pathogen and antibiotic sensitivity assays on the sputum specimens derived from 126 neonates with CAP admitted between Janua1 2011 and October 2012. Results： Of the 126 specimens analyzed, pathogenic bacteria were detected in 92 cases （73.0%）. Of 41 strains （44.6%） of Gram-positive cocci, 29 （70.7%） were Staphylococcus aureus strains. Of 1 strains （55.4%） of Gram-negative bacteria, 26 （51.0%） were Klebsiella pneumonae strains. There was a marked difference in the bacterial composition between sexes and among various levels of leukocyte count （ all P 〈 0.05）. The difference in effectiveness rate for the treatment of Gram-negative and Gram-positive bacterial infection did not reach statistical significance （both P 〉 0.05 ） between single （56.5% vs. 74.1% ） and combined empirical administration of antibiotics （ 45.0% vs. 55.0% ）. Conclusion ： CAP in neonates warrants active pathogenic and antibiotic sensitivity assay to steer clinical decision in terms of rational use of antibiotics.

关 键 词：社区获得性肺炎 新生儿 病原菌 药敏试验 

分 类 号：R563.1[医药卫生—呼吸系统]