新生儿重症监护室多重耐药感染分析  

Neonatal intensive care unit multi-resistant infections

作　　者：杨小兰[1] 李伟强[1] 黄春花[1] 邱淑妍 张必辉 

机构地区：[1]广东省惠州市第三人民医院检验科,广东惠州516002

出　　处：《世界中医药》2015年第A02期917-918,共2页World Chinese Medicine

摘　　要：目的探讨新生儿重症监护室多重耐药感染分析.方法：对我院2012年4月～2015年3月新生儿重症监护室收治的患儿1510例作为研究对象,通过收集痰液、血液、尿液、粪便、静脉置管、脐分泌物、眼耳分泌物以及脑脊液等标本,进行细菌培养鉴定与药敏试验,分析病原菌分布与耐药性.结果：1510例标本中共分离出阳性菌株167株,阳性率为11.1%：检出革兰阴性杆菌108株,占阳性菌株的64.7%,肺炎克雷伯菌居首位,为45例,其次是大肠埃希菌38例,铜绿假单胞菌7例,鲍曼不动杆菌9例,嗜麦芽窄食假单胞菌以及其他革兰阴性杆菌等9例等;检出革兰阳性球菌43株,占阳性菌株的25.7%,主要见于金黄色的葡萄球菌21例,凝固酶阴性葡萄球菌10例,粪肠球菌3例,肺炎链球菌5例,无乳链球菌4例;16株为真菌,占阳性菌株的9.6%,其中白假丝酵母菌10例,光滑假丝酵母菌4例,其他酵母菌2例.肺炎克雷伯菌对氨苄西林、头孢唑啉、对头孢曲松（或头孢噻肟）的耐药率分别为100%、68.9%、62.2%,对亚胺培南、头孢哌酮/舒巴坦的耐药率均为0;大肠埃希菌对氨苄西林、头孢唑啉、对头孢曲松（或头孢噻肟）的耐药率分别为89.5%、70.2%、68.4%,对亚胺培南、头孢哌酮/舒巴坦的耐药率均为0;金黄色葡萄球菌对青霉素G、红霉素、克林霉素、苯唑西林、头孢唑啉的耐药率分别为95.2%、81.0%、66.7%、42.9%,42.9%,对万古霉素、替考拉宁、呋喃妥因与利奈唑胺均为0%;凝固酶阴性葡萄球菌对青霉素G、苯唑西林、头孢唑啉、红霉素、克林霉素的耐药率分别为100%、90 %、90 %、80%、80%,对万古霉素、替考拉宁、呋喃妥因与利奈唑胺均为0%.结论：本组新生儿重症监护室多重耐药感染主要为革兰阴性病原菌感染,且对多数抗生素耐药.Objectiveto investigate the neonatal intensive care unit multi-resistant infections were analyzed. Methods：in our hospital in April 2012 to March 2015 at the records of children, 1510 cases of neonatal intensive care unit as the research object, through collecting the sputum, blood, urine, feces, venipuncture, umbilical discharge, eye and ear secretions and cerebrospinal fluid specimens, to identify the bacterial culture and drug sensitive test, analysis of pathogenic bacteria distribution and drug resistance. Results：positive strains was isolated 167 strains of a total of 1510 cases of specimens, the positive rate was 11.1% ： detected gram-negative bacilli 108 strains, accounting for 64.7% of the positive strains of klebsiella pneumoniae in the first place, for 45 cases, followed by e. coli 38 cases, 7 cases of pseudomonas aeruginosa, acinetobacter baumannii, 9 cases of eosinophilic malt narrow pseudomonas and other gram-negative bacillus and so on 9 cases, etc.; Check out 43 strains were gram positive coccus, accounting for 25.7% of the positive strains, mainly in the golden staphylococcus 21 cases, 10 cases were coagulase negative staphylococcus, 3 cases in enterococcus, streptococcus pneumoniae in 5 cases, 4 cases of non-dairy streptococcus; 16 strains of fungi, accounting for 9.6% of the positive strains, including 10 cases of white candida, smooth candida 4 cases, other yeast in 2 cases. Klebsiella pneumoniae to ampicillin, cefazolin, ceftriaxone （or cefotaxime） of ni is 100%, 68.9% and 62.2% respectively, the imine south, cefoperazone/shu ba＇s resistance to 0; E. coli to ampicillin, cefazolin, ceftriaxone （or cefotaxime） of ni is 89.5%, 70.2% and 68.4% respectively, the imine south, cefoperazone/shu ba＇s resistance to 0; Staphylococcus aureus to penicillin G, erythromycin, clindamycin, Westwood, cefazolin, benzene azole resistance were 95.2%, 81.0%, 66.7%, 81.0%, 42.9%, of vancomycin, their stead ning, with nitrofurantoin with rina thiazole amine were 0%; Coagulase negative staphylococcus

关 键 词：新生儿 重症监护室 多重耐药感染 

分 类 号：R446.5[医药卫生—诊断学]