甘肃省某三级甲等妇幼保健机构新生儿重症监护病房病原菌种类分布与耐药性分析  

Distribution of pathogenic species and drug resistance analysis in neonatal intensive care unit of a Grade Ⅲ Level A maternal and child health care hospital in Gansu

作　　者：邓晓辉[1] 李兰兰[1] 贺锐[1] 方惠娟[1] 周艳芝[1] DENG Xiao-Hui;LI Lan-Lan;HE Rui(Gansu Provincial Maternal and Child Health Care Hospital,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院

出　　处：《中国妇幼保健》2020年第1期54-56,共3页Maternal and Child Health Care of China

基　　金：甘肃省科技支撑计划项目(1304FKCA098)

摘　　要：目的分析甘肃省某三级甲等妇幼保健机构新生儿重症监护病房感染病原菌及耐药性,为临床治疗及感染防控提供科学依据。方法回顾性分析2016-2018年NICU各类标本所分离细菌的种类及主要菌种耐药性。结果NICU共分离病原菌414株,其中革兰阴性菌286株(69.08%),革兰阳性菌100株(24.15%),真菌28株(6.76%)。细菌培养标本共386例,主要为血液标本(194例,50.26%)。新生儿感染主要病原菌均存在多重耐药,革兰阴性菌对青霉素类耐药率普遍较高,对头孢曲松和头孢他啶的耐药性也应引起临床重视,但对氨基糖苷类及碳青霉烯类的敏感性较高;革兰阳性菌对青霉素和红霉素的耐药率较高,但对万古霉素和替考拉宁敏感性较高。结论新生儿重症监护病房病原菌以革兰阴性杆菌为主,耐药率较高,特别是肺炎克雷伯菌、鲍曼不动杆菌对多种抗菌药物耐药应引起重视,血液系统感染防控应作为NICU感染防控重点。Objective To analyze the distribution of pathogenic species and drug resistance analysis in neonatal intensive care unit of a GradeⅢLevel A maternal and child health care hospital in Gansu,provide a scientific basis for clinical treatment and infection prevention.Methods The species of bacteria and drug resistance of main bacteria isolated from various specimens in NICU from 2016 to 2018 were analyzed retrospectively.Results A total of 414 strains of pathogens were isolated in NICU,including 286 strains of Gram-negative bacteria(69.08%),100 strains of Gram-positive bacteria(24.15%),and 28 strains of fungi(6.76%).There were 386 bacterial culture specimens,194 specimens(50.26%)were isolated from blood.Multi-drug resistance was observed in main pathogens of neonatal infection,the drug resitance rates of Gram-negative bacteria to penicillins were high.Drug resistance of Gram-negative bacteria to ceftriaxone and ceftazidime should be paid more attention to,drug resistance rates to aminoglycosides and carbapenems were relatively high.Drug resistance rates of Gram-positive bacteria to penicillin and erythrocin were high,but drug resistance rates of Gram-positive bacteria to vancomycin and teicoplanin were relatively high.Conclusion In NICU,the main pathogen is Gram-negative bacilli,the drug resistance rate is high.More attention should be paid to the drug resistance of Klebsiella pneumoniae and Acinetobacter baumannii to multiple antibacterial agents,the prevention of blood system infection should be regarded as the key point of NICU infection prevention.

关 键 词：妇幼保健机构 新生儿 病原菌 耐药性 

分 类 号：R179[医药卫生—妇幼卫生保健]