我院2010-2013年新生儿败血症病原菌分布及耐药性分析  

Analysis of Pathogens Distribution and Antibiotics Resistance in Neonatal Septicemia Cases from 2010 to 2013 in Our Hospital

作　　者：蒋鸿超[1] 黄海林[1] 奎莉越[1] 苏敏[1] 樊茂[1] 

机构地区：[1]昆明医科大学附属儿童医院,云南昆明650000

出　　处：《儿科药学杂志》2015年第2期41-44,共4页Journal of Pediatric Pharmacy

摘　　要：目的:了解昆明地区新生儿血培养病原菌分布及耐药情况,为临床合理应用抗菌药物提供依据。方法:对我院2010年1月至2013年6月诊断或疑诊为败血症、菌血症的住院新生儿进行血培养检测,完成菌株鉴定及药敏试验,并进行统计分析。结果:15 560例新生儿血培养标本共检出病原菌423株,检出率2.72%(423/15 560),其中革兰阳性菌318株(75.18%,318/423),以凝固酶阴性葡萄球菌(表皮葡萄球菌和溶血葡萄球菌)为主(79.25%,252/318),表皮葡萄球菌在各年度比例均居于首位;革兰阴性菌105株(24.82%,105/423),以大肠埃希菌和肺炎克雷伯菌居多。药敏结果显示表皮葡萄球菌、溶血葡萄球菌对青霉素G敏感率最低,其次为红霉素、克林霉素、头孢唑林,敏感率均在30%以下,而对左氧氟沙星较敏感,未检出对万古霉素耐药的菌株。革兰阴性菌中产ESBLs大肠埃希菌、肺炎克雷伯杆菌的检出率均为65%,对头孢哌酮/舒巴坦、环丙沙星、亚胺培南较敏感,敏感率均在70%以上。结论:昆明地区新生儿血培养病原菌以革兰阳性菌为主,凝固酶阴性葡萄球菌是主要病原菌,部分表现为多重耐药,临床应引起重视,根据病原菌鉴定及药敏试验获得早期病原学诊断以及时进行抗菌治疗。Objective： To investigate the pathogens distribution and antibiotic resistance in neonatal septicemia cases in Kunming area, and provide evidence for clinical reasonable usage of antibiotics. Methods： The newborn positive results of blood cultures from Jan 2010 to June 2013 were identified and accomplished the antibiotics resistance test. Data analysis and statistical processing were done. Results： Four hundreds and twenty-three pathogenic strains were isolated from 15,560 specimens and the positive rate was 2.72%. Among them, 318 strains were gram-positive bacteria （75.18%） , and the eoagulase negative Staphylococcus （Staphylococcus epidermidis and Staphylococcus haemolyticus） was dominant （79. 25%）, the percentage of Staphylococcus epidermidis ranks top every year increasingly. One hundred and five strains were gram-negative bacteria （24. 82% ）, and the most were E. coli and Klebsiella pneumoniae. The results of drug sensitivity test showed that the sensitivity rate of Staphylococcus epidermidis and Staphylococcus haemolyticus to penicillin G was the lowest, the next were erythromycin, clindamycin, cefazolin which reached all less than 30% of the sensitivity rate. No Vancomycin resistant strain was found. Among gram-negative bacteria, the positive rates of E. coli and Klebsiella pneumoniae that produce extent-spectrum β-1actamases （ESBLs） were both 65%. And the sensitivity rates of them to cefoperazone/ sulbactam, ciprofloxacin and Imipenem were more than 70%. Conclusion： Gram-positive bacteria was the main pathogen causing neonatal septicemia in Kunming area. Among them, coagulase negative Staphylococcus is the main pathogens, and it shows partially trend of multi-drug resistant, more attention should be paid. It is important for clinicians to get the results of blood culture timely to give the children correct antibiotic therapy.

关 键 词：新生儿 血培养 耐药性 病原菌 

分 类 号：R722.1[医药卫生—儿科]