1132例早产儿感染病原菌的分布特征及耐药性分析  

Analysis of distribution characteristics of pathogenic bacteria and drug resistance in 1132 premature infants

作　　者：杜欣欣 张金铃 杨萌婷 王鉴 DU Xinxin;ZHANG Jinling;YANG Mengting;WANG Jian(School of Clinical Medicine,Guizhou Medical Universty,Guiyang 550000,Guizhou,China;Department of Neonatology,the Affilisted Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学临床医学院,贵州贵阳550000 [2]贵州医科大学附属医院新生儿科,贵州贵阳550004

出　　处：《贵州医科大学学报》2022年第8期910-915,共6页Journal of Guizhou Medical University

基　　金：贵州省卫生健康委科学技术基金项目(gzwjkj2020-1-142,gzwkj2022-136)。

摘　　要：目的 探讨新生儿重症监护病房(NICU)早产儿感染情况、病原菌分布及耐药性。方法 选取早产儿1 132例为研究对象,记录早产儿的性别、胎龄、出生体质量、主要诊断、侵袭性操作[气管插管、经外周中心静脉置管(PICC)]、机械通气情况、静脉营养及住院时间等资料,收集早产儿的血液、痰液、尿液、分泌物液或导管等病原菌标本,使用全自动微生物培养仪进行细菌培养,若24~48 h内出现细菌生长报警时采用全自动细菌鉴定药敏分析仪进行细菌鉴定及药敏试验。结果 1 132例早产儿感染检出率为52.12%(590/1 132),感染624例次,感染性疾病以肺炎为主、占67.95%(424/624),早产儿院内感染检出率为2.83%(32/1 132);早产儿各感染部位检出病原菌株271株,其中革兰阴性菌202株(74.54%),以肺炎克雷伯菌、黏质沙雷菌、大肠埃希菌为主,革兰阳性菌66株(24.35%)、以表皮葡萄球菌为主,真菌3株(1.11%)均为白假丝酵母菌;院内感染主要致病菌为革兰阴性菌、以黏质沙雷菌最为常见,均为多重耐药菌株(MDROs);主要革兰阴性菌对氨苄西林、第三代头孢菌素类耐药率为26.98%~96.92%;对碳青霉烯类抗生素耐药率低于10%;主要革兰阳性菌中,未检出对万古霉素、利奈唑胺耐药菌株。结论 NICU早产儿感染病原菌以革兰阴性菌为主;早产儿院内感染检出率总体较低,检出病原菌以黏质沙雷菌多见,且均为MDROs;常见革兰阴性菌对碳青霉烯类抗生素较敏感,主要革兰阳性菌对万古霉素、利奈唑胺均高度敏感。Objective To investigate the infection, pathogen distribution and drug resistance of premature infants in neonatal intensive care unit( NICU).Methods A total of 1 132 premature infants were selected as research subjects.Medical records of premature infants were documented,including gender, gestational age, birth body weight, major diagnosis, invasive procedures[tracheal intubation, peripherally inserted central catheter(PICC)], mechanical ventilation, venous nutrition,and length of hospital stay, etc.The blood, sputum, urine, secretions or catheters of premature infants were collected, and bacterial culture was conducted with automatic microbial culture instrument.If bacteria grew within 24-48 h, they triggered an alarm, which launched automatic bacterial identification and drug sensitivity analyzer to examine bacterial identification and drug resistance.Results The detection rate of the infections in 1 132 premature infants was 52.12%(590/1 132)with a total of 624 infections.Infectious diseases were mainly pneumonia, accounting for 67.95%(424/624), and the detection rate of nosocomial infection in premature infants was 2.83%(32/1 132).A total of 271 pathogenic strains were identified in all infection sites of premature infants,including 202(74.54%) gram-negative bacteria strains which were mainlyKlebsiella pneumoniae,Serratia marcescens, andEscherichia coli, and 66(24.35%) gram-positive bacteria strains which were mainlyStaphylococcus epidermidis, 3(1.11%) fungal strains which wereCandida albicans.The main pathogens of nosocomial infections were gram-negative bacteria, andS.marcescenswas the most common form and multidrug-resistant organisms(MDROs).Resistance rates of the main gram-negative bacteria to ampicillins and third-generation cephalosporins were 26.98%-96.92%, while the resistance rate to carbapenems was less than 10%.None of the main gram-positive bacteria was resistant to vancomycin and linezolid.Conclusion Gram-negative bacteria are the main pathogens of infections in premature infants in NICU.The de

关 键 词：感染 早产儿 院内感染 抗生素类 病原菌 耐药性 

分 类 号：R722.1[医药卫生—儿科]