NICU多重耐药菌筛查及耐药性分析  

Multidrug-resistant bacteria screening and drug resistance analysis in NICU

作　　者：谢建宁[1] 王兆莉[1] 戴怡蘅[1] 刘卫东[1] 李相新[1] 

机构地区：[1]南方医科大学附属佛山市妇幼保健院,广东佛山528000

出　　处：《中国妇幼保健》2016年第22期4744-4746,共3页Maternal and Child Health Care of China

基　　金：佛山市科技局基金资助(2014AB00383)

摘　　要：目的通过对新生儿重症监护病房(NICU)住院患儿多重耐药菌的定植状况以及耐药特点调查分析,为预防和控制多重耐药菌在院内的传播及临床合理用药提供科学依据。方法对2015年5月-2016年5月在医院NICU住院治疗的患儿进行细菌学监测,取198例患儿鼻咽拭子和直肠拭子进行筛查培养并做药敏试验,采用WHONET 5.6软件进行细菌耐药性分析。结果在26例患儿标本中检测到多重耐药菌,多重耐药菌定植率13.13%。监测目标菌中包括24株产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌和2株耐甲氧西林金黄色葡萄球菌(MRSA),未检测到多重耐药的鲍曼不动杆菌和铜绿假单胞菌。24株产ESBLs肠杆菌科细菌对氨苄西林、哌拉西林、头孢唑啉的耐药率极高为100.00%;21株肺炎克雷伯菌对亚胺培南及美罗培南的耐药率为42.86%;2株耐甲氧西林金黄色葡萄球菌对万古霉素、喹奴普汀、利奈唑胺敏感。结论该院NICU住院患儿多重耐药菌定植率较高,耐药现象严重。应引起临床医生的高度重视,加强监测,避免多重耐药菌在医院暴发流行。Objective To survey and analyze colonization and drug resistance characteristics of multidrug-resistant bacteria isolated from Neonatal Intensive Care Unit （NICU） children, provide a scientific basis for preventing and controlling transmission of muhidrug-resist- ant bacteria in the hospital and clinical rational drug use. Methods Bacteriological surveillance was conducted among the children in NICU of the hospital from May 2015 to May 2016, the nasopharyngeal swabs and rectal swabs of 198 children were obtained for screening, culture, and drug sensitive test, WHONET 5.6 software was used to analyze bacterial drug resistance. Results Multidrug-resistant strains were detected among 26 children, the colonization rate was 13.13%, including 24 strains of extended-spectrum 13 lactamases （ESBLs） -producting Enterobacteriaceae bacteria and 2 strains of methicillin-resistant Staphylococcus aureus （MRSA） . Multidrug-resistant Acinetobacter baumannil and Pseudomonas aeruginosa were not detected. The drug resistance rate of 24 strains of ESBLs-producting Enterobacteriaceae bacteria to ampicillin, piperacillin, and cefazolin was 100. 00% ; the drug resistance rate of 21 strains of Klebsiella pneumoniae to imipenem and meropenem was 42. 86% ; 2 strains of MRSA were sensitive to vacocin, linezolid, and quinupristin. Conclusion The colonization rate of multi- drug-resistant bacteria is high among NICU children in the hospital, drug resistance is serious. More attention should be paid to this phenomenon by clinicians, monitoring should be enhanced to avoid epidemic outbreak of multidrug-resistant bacteria in hospitals.

关 键 词：新生儿重症监护病房 多重耐药主动筛查 医院感染 耐药性分析 

分 类 号：R722[医药卫生—儿科]