早产儿肺炎克雷伯菌感染临床分析  

Clinical analysis on Klebsiella pneumoniae infection in preterm infants

作　　者：游楚明[1] 陈历耋[1] 谢燕丕[1] 王玉[1] 梁振宇[1] 孟琼[1] 傅万海[1] 

机构地区：[1]广东省第二人民医院儿科,中国广州510317

出　　处：《中国妇幼健康研究》2017年第10期1299-1301,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的了解广东省第二人民医院新生儿重症监护室(NICU)早产儿肺炎克雷伯菌感染的发生率、危险因素、分布情况及耐药情况。方法回顾性分析广东省第二人民医院2010年3月至2015年3月期间收治的早产儿1 716例,对52例发生肺炎克雷伯菌感染患儿的一般资料、相关因素、药敏分析等情况进行统计分析。结果 1 716例早产儿中52例发生肺炎克雷伯菌感染,其感染率为3.15%,感染中位数为15.9天,平均数为19.3±12.7天;其中血行感染36例,肺部感染16例;药敏分析显示其对三代头孢耐药率为88.5%~100%,对四代头孢耐药率为88.5%,未发现对哌拉西林他唑巴坦、头胞哌酮舒巴坦及碳青霉烯类抗生素耐药菌。其中超广谱β-内酰胺酶(ESBL)(+)21例,耐药率远高于ESBL(-)菌株。结论肺炎克雷伯菌是NICU医院感染的重要病原菌,以血行感染为主,且耐药发生率高,迫切需要加强院感防控措施,合理使用抗生素,减少侵入性操作及加强手卫生,减少医院感染的发生。Objectve To understand the incidence,risk factors,distribution and drug resistance of Klebsiella pneumoniae infection in premature infants in neonatal intensive care unit（ NICU） of Guangdong Second People＇s Hospital. Methods A retrospective analysis was done on 1 716 cases of preterm infants admitted in Guangdong Second People＇s Hospital from March 2010 to March 2015,among which 52 cases had Klebsiella pneumoniae infection and all were hospital infection. General information,relevant factors and drug sensitivity of Klebsiella pneumoniae infection of cases were statistically analyzed,and data was analyzed using SPSS17. 0. Results There were 52 cases infected with Klebsiella pneumoniae among 1 716 preterm infants,with an infection rate of 3. 15%. Median number of infection was 15. 9 days,and average infection time was 19. 3 ± 12. 7 days. Thirty-six cases were hematogenous infection,and 16 cases were pulmonary infection. Drug sensitivity analysis showed that its resistance rate to third generation cephalosporin was 88. 5%-100%,and to fourth generation cephalosporin was 88. 5%. Bacteria resistant to piperacillin tazobactam,cefoperazone sulbactam and carbapenems was not found. Twenty-one cases were with extended spectrum β-lactamase EBSL（ ＋）,whose drug resistance was much higher than that of EBSL（-） strains. Conclusion Klebsiella pneumoniae is an important pathogen in NICU hospital infection,and hematogenous infection is the main factor. Incidence of drug resistance is high. Strengthening of hospital infection prevention and control measures is urgently needed.Rational use of antibiotics is recommended. Invasive procedure should be reduced and hand hygiene be enhanced in order to reduce hospital infection.

关 键 词：肺炎克雷伯 交叉感染 婴儿 新生 革兰阴性菌 

分 类 号：R725.1[医药卫生—儿科]