某院新生儿病区2013-2019年病原特点及变迁  

Characteristics and Changes of Pathogens in the Neonatal Ward of a Hospital from 2013 to 2019

作　　者：郑盼盼[1] 陈锡创 洪远[3] 朱扣柱 叶振 Zheng Panpan;Chen Xichuang;Hong Yuan;Zhu Kouzhu;Ye Zhen(Ningbo No.6 Hospital,Zhejiang Ningbo 305040,China;Wuxi No.9 People’s Hospital,Wuxi No.9 People’s Hospital Affiliated to Suzhou University,Jiangsu Wuxi 214062,China;Wuxi Children’s Hospital Affiliated to Nanjing Medical University,Jiangsu Wuxi 214023,China;Suqian Branch Jiangsu Province Hospital,Suqian First Hospital,Jiangsu Suqian 223080,China)

机构地区：[1]浙江省宁波市第六医院,浙江宁波305040 [2]无锡市第九人民医院,苏州大学附属无锡九院,江苏无锡214062 [3]南京医科大学附属无锡儿童医院,江苏无锡214023 [4]江苏省人民医院宿迁分院,宿迁市第一人民医院,江苏宿迁223080

出　　处：《儿科药学杂志》2021年第11期31-35,共5页Journal of Pediatric Pharmacy

基　　金：无锡市“双百”中青年医疗卫生拔尖人才项目,编号HB2020115、BJ2020087;江苏省医学青年人才项目,编号QNRC2016485。

摘　　要：目的:分析江苏省无锡市儿童医院新生儿病区病原菌的分布、耐药及其变迁情况,为经验治疗提供依据。方法:使用WHONET 5.4分析送检的标本情况,参照美国临床实验室标准化协会(CLSI)标准,分离病原菌并进行药敏培养。结果:2013-2019年新生儿病区共送检17930份标本,分离1267株菌,检出率为6.89%,其中G+菌890株(70.24%),G-菌348株(27.47%),真菌29株(2.29%)。排前5位的依次为表皮葡萄球菌、金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、溶血葡萄球菌。药敏结果提示耐甲氧西林金黄色葡萄球菌(MRSA)检出比例已上升至42.6%;大肠埃希菌产超广谱β-内酰胺酶(ESBLs)比例较前有所下降,而肺炎克雷伯菌产ESBLs比例较前有所上升,但这两种菌株对头霉素类及含酶抑制剂复方制剂敏感性均较好。结论:我院新生儿病区病原菌MRSA菌株有上升趋势,G-菌耐药也仍较普遍,需加强医院感染的防控,结合患儿的病情经验性选择合适的抗感染药物治疗,减少细菌耐药菌发生。Objective:To analyze the distributions,drug resistance and changes of pathogens in the neonatal ward of Jiangsu Wuxi Children’s Hospital,so as to provide basis for empirical treatment.Methods:Samples were analyzed by using WHONET 5.4,and the pathogens were isolated and cultured in accordance with the American Clinical Laboratory Standard Institute(CLSI)standards.Results:From 2013 to 2019,totally 17,930 specimens were sent to the neonatal ward and 1,267 strains were isolated,with the detection rate of 6.89%,including 890 strains(70.24%)of G;bacteria,348 strains(27.47%)of G;bacteria,and 29 strains(2.29%)of fungi.The top five bacteria were respectively Staphylococcus epidermis,Staphylococcus aureus,Escherichia coli,Klebsiella pneumoniae and Staphylococcus haemolyticus.Drug sensitivity results showed that the detection rate of methicillin-resistant S.aureus(MRSA)increased to 42.6%.The proportion of extended spectyumβ-lactamase(ESBLs)-producing E.coli decreased,while that of K.pneumoniae increased,but the two strains were more sensitive to the compound preparation ofβ-lactamase and enzyme inhibitor.Conclusion:MRSA strains of pathogens in neonatal ward of our hospital are on the rise,and drug-resistant G;bacteria are still common.Therefore,prevention and control of hospital-acquired infection should be strengthened,and appropriate anti-infective drugs should be selected empirically based on the condition of children,so as to reduce the occurrence of drug-resistant bacteria.

关 键 词：新生儿 病原菌 耐药性 抗菌药物治疗 

分 类 号：R722.1[医药卫生—儿科]