早产儿重症监护病房肺炎克雷伯菌败血症临床分析  

Drug Sensitivity of Klebsiella Pneumoniae Sepsis in Premature Infants from Intensive Care Unit

作　　者：常淑婷[1] 刘新晖[1] 李强[1] 马金霞[1] 李军帅 高喜容[1] Chang Shuting;Liu Xinhui;Li Qiang;Ma Jinxia;Li Junshuai;Gao Xirong(Hunan Children's Hospital,Hunan Changsha 410007,China)

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《儿科药学杂志》2019年第6期49-52,共4页Journal of Pediatric Pharmacy

摘　　要：目的:了解早产儿重症监护病房医院感染肺炎克雷伯菌败血症的临床及药敏情况,为合理应用抗菌药物提供参考。方法:对肺炎克雷伯菌进行超广谱β-内酰胺酶(ESBLs)检测,并以此分为产ESBLs组及非产ESBLs组,对两组患儿一般资料及药敏试验结果进行比较。结果:手术史、胎龄(<30周)为产ESBLs感染的危险因素,OR值分别为10. 68(95%CI 1. 75,64. 26,P<0. 05)及6. 98(95%CI 1. 82,28. 51,P<0. 05)。产ESBLs感染后患儿总机械通气时间、住院天数延长,但与不产ESBLs感染的患儿预后比较,差异无统计学意义(P>0. 05)。产ESBLs组对β-内酰胺类抗菌药物、头孢菌素、氨曲南、复方磺胺甲唑等抗菌药物敏感性显著低于非产ESBLs组,差异有统计学意义(P<0. 05)。结论:早产儿肺炎克雷伯菌败血症中产ESBLs菌发生率高,耐药性强,临床医师应根据药敏结果选择合理抗菌药物,及时控制病情进展,提高治愈率。Objective:To investigate the drug sensitivity of Klebsiella Pneumoniae sepsis in premature infants from intensive care unit(ICU),so as to provide reference for the rational application of antibiotics.Methods:Klebsiella pneumoniae was detected by extended spectrumβ-lactamases(ESBLs)and divided into ESBLs-producing group and non-ESBLs-producing group.The general data and drug susceptibility results of the two groups were compared.Results:Surgical history and gestational age(<30 weeks)were risk factors for ESBLs infection,OR values were 10.68(95%CI 1.75,64.26,P<0.05)and 6.98(95%CI 1.82,28.51,P<0.05),respectively.The total duration of mechanical ventilation and the length of stay were prolonged after ESBLs infection,yet the difference was not statistically significant compared with the prognosis of children without ESBLs infection(P>0.05).The sensitivity of antibiotics such asβ-lactam antibiotics,cephalosporin,aztreonam and compound sulfamethoxazole was significantly lower in the ESBLs-producing group than in the non-ESBLs group(P<0.05).Conclusion:Klebsiella pneumoniae sepsis in premature infants has a relatively high incidence of ESBLs and strong drug resistance.Appropriate antiiotics should be selected according to the drug sensitivity results to timely control the disease progression and improve the cure rate.

关 键 词：肺炎克雷伯菌 药敏试验 超广谱Β-内酰胺酶 早产儿 

分 类 号：R725.6[医药卫生—儿科]