凉山彝族自治州彝族新生儿败血症病原菌分布及其耐药性分析  

Analysis of bacteria and drug resistance in blood culture of neonatal septicemia of Yi nationality in Liangshan Yi Autonomous Prefecture

作　　者：边程鹏[1] 张月 BIAN Cheng-peng;ZHANG Yue(Department of Pediatrics,the First People's Hospital of Liangshan Yi Autonomous Prefecture,Sichuan,Xichang 615000,China)

机构地区：[1]凉山彝族自治州第一人民医院儿科

出　　处：《中国医学前沿杂志（电子版）》2019年第8期50-54,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：四川省卫生厅科研课题(110070)

摘　　要：目的探讨凉山彝族自治州彝族新生儿败血症病原菌分布及其耐药性。方法回顾性分析2013年3月至2018年3月本院收治的彝族败血症新生儿与汉族败血症新生儿的病原菌分布和耐药情况。结果两组患儿血培养阳性菌株为243株,分离出18种病原菌,其中革兰氏阳性菌212株(87.2%),彝族组111株(84.1%),汉族组101株(91.0%),两组比较差异无统计学意义(P > 0.05);革兰氏阴性菌31株(12.8%),彝族组21株(15.9%),汉族组10株(9.0%),两组比较差异无统计学意义(P >0.05)。两组革兰氏阳性致病菌均以表皮葡萄球菌、溶血葡萄球菌为主,革兰氏阴性致病菌均以大肠埃希菌为主。两组患儿表皮葡萄球菌、溶血葡萄球菌、人葡萄球菌对青霉素和红霉素的耐药率均达80%以上,部分耐药率达100%;对氨苄西林的耐药率达70%以上,对苯唑青霉素耐药率达50%以上。两组中均未发现对万古霉素耐药的葡萄球菌。彝族组患儿表皮葡萄球菌对苯唑青霉素、左氧氟沙星、环丙沙星、庆大霉素和利福平的耐药率均显著高于汉族组(均P < 0.05)。彝族组患儿溶血葡萄球菌对苯唑青霉素的耐药率显著低于汉族组(P < 0.05),大肠埃希菌对氨苄西林的耐药率显著低于汉族组(P < 0.05),两组患儿大肠埃希菌对哌拉西林他唑巴坦和亚胺培南均无耐药。结论早期加强对新生儿败血症病原菌的鉴定和耐药性分析有助于指导临床合理使用抗菌药物,改善患儿预后。Objective To investigate the distribution of pathogens and drug resistance of the newborn of Yi nationality in Liangshan Yi Autonomous Prefecture. Method The distribution and drug resistance of pathogenic bacteria in newborns with Yi nationality and Han nationality septicemia of newborn treated in our hospital from March 2013 to March 2018 were analyzed retrospectively. Result There were 243 positive strains of blood culture in the two groups, and 18 kinds of pathogenic bacteria were isolated, including 212 strains of Gram-positive bacteria (87.2%), 111 strains in Yi nationality group (84.1%) and 101 strains in Han nationality group (91.0%), there was no significant difference between the two groups (P > 0.05). There were 31 strains of Gram-negative bacteria (12.8%), 21 strains of Yi nationality group (15.9%) and 10 strains of Han nationality group (9.0%), there was no significant difference between the two groups (P > 0.05). Staphylococcus epidermidis and Staphylococcus haemolyticus were the main Gram-positive bacteria in both groups, and Escherichia coli was the main Gram-negative bacteria in both groups. The resistance rates of Staphylococcus epidermidis, Staphylococcus haemolyticus and Staphylococcus hominis to Penicillin and Erythromycin in both group more than 80%, and the partial resistance rates were 100%, the resistance rates to Ampicillin and Oxacillin were more than 70% and 50%, respectively. No Vancomycin resistant Staphylococcus was found in both groups. The resistance rates of Staphylococcus epidermidis to Oxacillin, Levofloxacin, Ciprofloxacin, Gentamicin and Rifampicin in Yi nationality group were significantly higher than those in Han nationality group (all P < 0.05). The resistance rate of Staphylococcus haemolyticus to Oxacillin in Yi nationality group was significantly lower than that in Han nationality group (P < 0.05). The resistance rate of Escherichia coli to Ampicillin in Yi nationality group was significantly lower than that in Han nationality group (P < 0.05). There were no Escherichia

关 键 词：彝族 新生儿败血症 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R722.131[医药卫生—临床医学]