无锡市儿童医院10386份新生儿血培养病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens isolated from 10 386 neonatal blood culture in Wuxi Children’ s hospital

作　　者：张岩[1] 董亮 张秀红 钱俊 ZHANG Yan;DONG Liang;ZHANG Xiu-hong;QIAN Jun(Wuxi Hospital for Maternal and Child Health Care Affiliated to Nanjing Medical University,Wuxi,Jiangsu 214002,China)

机构地区：[1]南京医科大学附属无锡妇幼保健医院,江苏无锡214000 [2]南京医科大学附属无锡人民医院,江苏无锡214023

出　　处：《现代预防医学》2019年第15期2820-2823,共4页Modern Preventive Medicine

基　　金：国家自然科学基金(81400054);无锡市科技发展指导性计划(CSZ0N1604);无锡市卫计委适宜技术推广项目(T201749);无锡市人民医院院内课题(RKB201718)

摘　　要：目的了解无锡市儿童医院新生儿败血症病原菌种类及耐药性。方法回顾性分析该院2013-2017年新生儿血培养病原菌的分布特点及耐药情况。结果 10 386份标本检出病原菌432株,检出率前4位为表皮葡萄球菌、溶血葡萄球菌、大肠埃希菌及肺炎克雷伯菌。表皮葡萄球菌、溶血葡萄球菌检出率由2013年的50.67%、20.00%下降至2017年的28.18%、17.27%;而大肠埃希菌和肺炎克雷伯菌检出率分别由2013年的4.00%、2.67%上升至2017年的13.64%、11.82%。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率(74.10%~90.00%)高于耐甲氧西林金黄色葡萄球菌(MRSA)的检出率(28.57%)。溶血葡萄球菌对抗菌药物耐药率高于表皮葡萄球菌,其对左氧氟沙星、环丙沙星、红霉素、苯唑西林和青霉素耐药率73.75%~93.75%。肺炎克雷伯菌、大肠埃希菌对亚胺培南耐药率分别为20.00%、0,两者均对哌拉西林/他唑巴坦、氨曲南、阿米卡星及妥布霉素敏感,耐药率≤9.52%。结论凝固酶阴性葡萄球菌(CNS)和肠杆菌属是新生儿败血症常见病原菌,不同年份不同病原菌检出率变化趋势存在差异,表皮葡萄球菌检出率明显下降,肠杆菌属检出率增加。CNS中溶血葡萄球菌对抗菌药物耐药性严重,亚胺培南耐药肺炎克雷伯菌检出率较高。Objective To investigate the distribution and drug resistance of pathogens isolated from neonates with sepsis in Wuxi Children’s hospital.Methods A retrospective analysis was conducted for the distribution characteristics and drug resistance of pathogens in neonatal blood culture from 2013 to 2017.Results A total of 432 strains of pathogens were isolated from 10 386 specimens.The top 4 detected pathogens were Staphylococcus epidermidis,Staphylococcus haemolyticus,Escherichia coli and Klebsiella pneumoniae.The detection rates of Staphylococcus epidermidis and Staphylococcus haemolyticus decreased from 50.67%,20.00% to 28.18% and 17.27% between 2013 and 2017.The detection rates of Escherichia coli and Klebsiella increased from 4.00%,2.67% to 13.64% and 11.82%.The detection rates of methicillin-resistant CNS(MRCNS)and Staphylococcus aureus(MRSA)were varying from 74.10% to 90.00% and 28.57%,respectively.The resistance rate of Staphylococcus haemolyticus to antibiotics was higher than that of Staphylococcus epidermidis.The resistant rate of Staphylococcus hominis to levofloxacin,ciprofloxacin erythromycin,oxacillin and penicillin was ranged from 73.75% to 93.75%.The resistant rate of Escherichia coli and Klebsiella pneumoniae to imipenem was 0 and 20.00%,respectively.Both Escherichia coli and Klebsiella pneumoniae were sensitive to piperacillin-tazobactam,aztreonam,amikacin and tobramycin,and the resistant rate was less than 9.52%.Conclusion CNS and Enterobacteriaceae coli are the main bacteria in blood culture isolated from neonates with sepsis.The detection rates caused by different pathogens are different.The detection rate of Staphylococcus epidermidis decreases significantly over the past five years,whereas the detection rates of Enterobacteriaceae coli increases during the same period.The drug resistance of Staphylococcus haemolyticus to antibiotics is the most serious in CNS.Meanwhile,the detection rate of imipenem resistant Klebsiella pneumoniae was high.

关 键 词：新生儿 血培养 病原菌 分布 耐药性 

分 类 号：R115[医药卫生—公共卫生与预防医学]