胆红素脑病新生儿感染病原菌分布与耐药性研究  

Bacteria distribution and drug resistance in neonatal with bilirubin encephalopathy

作　　者：张莹[1] 艾雪梅[1] 梁庆红[1] 赵萌[1] 张琳[1] 

机构地区：[1]河北医科大学第三医院儿科,河北石家庄050051

出　　处：《中华医院感染学杂志》2015年第24期5702-5704,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医学科学研究重点基金资助项目(20110434)

摘　　要：目的对胆红素脑病新生儿病原菌感染与耐药性进行调查和分析,探讨针对不同病原菌感染的抗菌药物选择,为临床治疗提供参考依据。方法收集2010年1月-2015年1月1 008例符合胆红素脑病的新生儿临床资料,对其发生感染新生儿送检的标本进行病原菌培养和药敏试验,并对检验结果进行分析。结果 1 008份标本共检出病原菌282株,分别检出153株革兰阳性菌、121株革兰阴性菌和8株真菌,分别占54.3%、42.9%和2.8%;其中金黄色葡萄球菌和表皮葡萄球菌的检出率最高,分别占27.3%和19.3%,肺炎克雷伯菌、大肠埃希菌检出率较高,分别占23.0%和17.7%,革兰阳性菌对阿莫西林/克拉维酸、替考拉宁和万古霉素的敏感性最高;革兰阴性菌对头孢西丁、头孢他啶、哌拉西林/他唑巴坦敏感性最高,产超广谱β-内酰胺酶(ESBLs)菌对头孢吡肟、头孢曲松和头孢噻肟耐药性最高。结论胆红素脑病新生儿病原菌感染以革兰阳性菌为主,在临床治疗过程中应对感染病原菌进行持续性的监测,了解其特点,并在抗菌药物选择上给予适当的调整。OBJECTIVE To observe the characteristics of distribution and drug resistance of pathogenic bacteria in neonatal with bilirubin encephalopathy so as to discuss the selection of antibacterial for different bacterial infections in clinical practice. METHODS The pathogenic bacteria culture and drug susceptibility experiment of various clinical specimens of 1008 cases of neonatal with bilirubin encephalopathy admitted from Jan. 2010 to Jan. 2015 were retrospectively analyzed. RESULTS There were 282 strains of pathogens isolated from 1008 specimens, including 161 strains of gram-positive bacteria, 113 strains of gram-negative bacteria and 8 strains of fungi, and the detection rates were respectively 40.1 %, 57.1% and 2.8%. The gram-positive bacteria were given priority to Staphylococcus aureus and Staphylococcus epidermis, and the detection rates were respectively 27.3% and 19.3%. The gram negative bacteria was given priority to Klebsiella bacillus and Escherichia coli, with the detection rates of respectively 23.0% and 17.7% ; S. aureus and S. epidermis of gram-positive bacteria showed the highest sensitivity to amoxicillin/clavulanic acid, teicoplanin and vancomycin, and showed the highest resistance to azithromycin, ampicillin and cenicillin G; Klebsiella pneumoniae and Escherichia coli of gram negative bacteria were characterized by the highest sensitivity to cefoxitin and ceftazidime, piperacillin-tazobactam, and ultra broad spectrum beta lactamase （ESBLs） （＋） bacteria were proved to be the most resistant to cefepime, ceftriaxone and cefotaxime. CONCLUSION Neonatal bilirubin encephalopathy is mainly infected by gram-positive bacteria. During clinical treatments, the pathogenic bacteria should be continuously monitored to understand the features so that the selection of antibiotics can be adjusted properly.

关 键 词：胆红素脑病 新生儿 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]