住院新生儿临床分离病原菌及其耐药性分析  

Pathogens distribution and resistance of clinical specimens in neonatal department

作　　者：李静静[1] 刘妙玲[1] 吴菲[1] 黄建英[1] 邹晓妮[1] 

机构地区：[1]广东省妇幼保健院医院感染管理科,广州市510010

出　　处：《实用医学杂志》2017年第17期2869-2872,共4页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金项目(编号:B2015136)

摘　　要：目的分析住院新生儿临床分离病原菌的分布特点及药敏结果,为临床合理选择抗菌素提供参考。方法以新生儿临床标本中分离出病原菌为研究对象,分析病原菌的分布及耐药特点。15 796份标本按操作规范培养分离,经全自动细菌鉴定系统VITEK-2 compact进行鉴定及药敏试验,应用WHONET5.4软件分析药敏结果。结果共分离病原菌1 125株,阳性率为7.1%,G-菌742株,占66.0%;G+菌355株,占31.6%,肺炎克雷伯菌和金黄色葡萄球菌分别占G-菌和G+菌的首位。G-菌对氨苄西林、一/二代头孢等耐药率较高,肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的抵抗率>24.0%。葡萄球菌中的MRSA和MRSCN的检出率分别是35.7%、73.3%,对青霉素、头孢类、红霉素等不同程度耐药,对万古霉素、替加环素等100%敏感。结论住院新生儿临床分离的病原菌以G-杆菌和葡萄球菌为主,耐药性较为严重。Objectives To analyze the distribution and drug resistance of pathogenic bacteria in neonatal department, and to provide criteria for rational clinical use of antibiotics. Methods Totally 15,796 specimens obtained from neonates were cultured according to the operation specification. The isolated pure strains were identified and their drug susceptibility was tested by VITEK-2 automated microorganism identification system. Results A total of 1,125 strains of bacteria were isolated and the total detection rate was 7.1%. Of the total, 742 （66.0%） were gram-negative bacteria, 355 （31.6%） gram-positive bacteria and 28 （2.4%） fungi. K pneumonia was the most frequently isolated pathogen in gram-negative bacteria, and staphylococcus the most frequently isolated pathogen in gram-positive bacteria. G- bacteria were highly resistant to ampieillin, 1^st and 2^nd generation cephalosporin. The resistant rates of K pneumonia, P aeruginosa and A baumannii to imipenem were 〉24.0% o Among the staphylococcus, 35.7% were MRSA and 73.3% MRSCN. The antibiotic sensitivities of staphylococcusto vancomycin, Rina thiazole alkanes and Tigecycline were 100.0%, but those to penicillin, cephalosporin and erythromycin low. Conclusion The dominant bacteria isolated from specimens obtained from neonates are gram-negativebacteria, and they present extensive antibiotic resistance.

关 键 词：病原菌 药敏分析 耐药性 新生儿 

分 类 号：R446.5[医药卫生—诊断学] R722.1[医药卫生—临床医学]