新生儿败血症病原菌变迁及耐药性分析  

The Investigation of the Pathogen and Drug Resistance of Neonatal Sepsis

作　　者：陈健萍[1] 欧阳颖[2] 曾爱红[3] 陈志凤[1] 袁海超[1] CHEN Jian-ping;OU YANG Ying;ZENG Ai-hong;CHEN Zhi-feng;YUAN Hai-chao(Department of Neonatology,Dongguan People＇s Hospital,Dongguan 523000;Department of Pediatrics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou;The First Affiliated Hospital of Sun Yat-sen University)

机构地区：[1]东莞市人民医院新生儿科,523000 [2]中山大学孙逸仙纪念医院新生儿区 [3]中山大学附属一医院

出　　处：《岭南急诊医学杂志》2018年第5期437-440,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:分析本院区近六年来新生儿败血症病原菌及其耐药性变迁,以指导临床用药。方法:收集2010年1月至2015年12月本院收治的经血培养确诊为新生儿败血症患儿的临床资料,对血培养检出菌及药敏试验结果进行回顾性分析。结果:共检出病原菌263株,革兰氏阳性菌(G+菌)占58.2%,其中凝固酶阴性葡萄球菌(Coagulase negative staphylococci,CONS)占40.3%;革兰氏阴性菌(G-菌)占41.8%,其中大肠埃希菌检出率最高,占25.1%。前三位病原菌依次为:CONS、大肠埃希菌、无乳链球菌。无乳链球菌检出率在2010-2015年间的差异有统计学意义(P<0.05),呈上升趋势。葡萄球菌对苄青霉素、克林霉素普遍耐药,未发现万古霉素耐药株;革兰氏阴性菌对氨苄西林耐药性高,对β-内酰胺酶抑制剂复合物较敏感,对碳青霉烯类敏感。结论:CONS是本院新生儿败血症最主要的致病菌。主要的G+菌和G-菌分别对万古霉素、碳青霉烯类抗菌药物敏感。无乳链球菌感染有所增加,易并发化脓性脑膜炎。Objective ： To investigate the pathological spectrum of neonatal sepsis and antibiotic resistance of bacteria in last six years for guiding clinical medication. Methods ： Clinical information of neonates with sepsis admitted to our Hospital were retrospectively collected from January 2010 to December 2015 and analyzed. Results： During the study period, a total of 263 pathogen were cultured. The gram positive bacteria accounted for 58.2% while the gram negative bacteria for 41.8%. The detection rate of coagulase negative staphylococci （CONS） was 40.3%, While E.coli was the highest in the gram negative bacteria, accounting for 25.1%. The first three pathogens of neonatal sepsis were coagulase negative staphylococci, E.coli and Streptococci agalactiae. The infection rate of streptococci agalactiae between 2010-2015 years increased every year. And the difference was significant （P〈0.05）. Streptococcus was resistant to penicillin, clindamycin. We did not identify any gram positive bacterial resistant to vancomycin. In general, the gram negative bacteria were resistant to ampicillin, sensitive to the beta lactamase inhibitor compound preparation, and highly sensitive to carbapenems. Conclusion： Neonatal sepsis were mainly caused by CONS. The gram positive bacteria were sensitive to vancomycin and, the gram negative bacteria were sensitive to carbapenems. There was an upward trend in Streptococcus agalactiae infection. Streptococcus agalactiae infections were easily complicated with bacterial meningitis.

关 键 词：新生儿败血症 病原菌 耐药性 

分 类 号：R722.131[医药卫生—儿科]