新生儿血流感染病原菌分布及耐药性分析  

Distribution and drug resistance analysis of pathogenic bacteria in neonatal blood flow infection

作　　者：王文英[1] 张佩佩 王莹莹 金闪闪 WANG Wenying;ZHANG Peipei;WANG Yingying;JIN Shanshan(Huaihe Hospital of Henan University,Kaifeng 475000,Henan,China;Kaifeng People's Hospital)

机构地区：[1]河南大学淮河医院,河南开封475000 [2]开封市人民医院

出　　处：《中国病原生物学杂志》2023年第9期1088-1091,共4页Journal of Pathogen Biology

摘　　要：目的 分析开封市新生儿血流感染病原菌分布及对主要抗菌药物的耐药性。方法 回顾性分析本院新生儿科收治的212例新生儿血流感染病例临床资料。收集患儿临床资料,根据新生儿胎龄及出生体质量进行分组。采集患儿静脉血,全自动血培养仪进行培养,培养纯化后,全自动细菌鉴定仪进行病原菌鉴定。使用Kirby Bauer纸片扩散法检测主要病原菌耐药性。结果 共检出病原菌212株,其中,革兰阳性菌125株(58.96%),革兰阴性菌67株(31.61%),真菌20株(9.43%)。革兰阳性菌主要为表皮葡萄球菌(87株)、金黄色葡萄球菌(12株)。革兰阴性菌主要为肺炎克雷伯菌(25株,11.79%)、大肠埃希菌(13株,6.13%)。真菌主要为白色假丝酵母菌(12株,5.66%)。对比不同胎龄新生儿感染主要病原菌的分布情况,肺炎克雷伯菌、大肠埃希菌、白色假丝酵母菌、光滑假丝酵母菌构成比差异有统计学意义(均P<0.05)。对比不同出生体质量新生儿感染主要病原菌的分布情况,表皮葡萄球菌、人葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、白色假丝酵母菌构成比差异有统计学意义(均P<0.05)。表皮葡萄球菌、金黄色葡萄球菌对青霉素G全部耐药,未检出对利奈唑胺、万古霉素、替考拉宁、呋喃妥因耐药株,对苯唑西林、庆大霉素、红霉素、左氧氟沙星的耐药率较高。肺炎克雷伯菌、大肠埃希菌对氨苄西林全部耐药,未检出对亚胺培南耐药株。真菌对两性霉素B、氟康唑、伏立康唑、伊曲康唑的耐药率较低,未检出对氟胞嘧啶耐药株。结论 开封市新生儿血流感染病原菌以革兰阳性菌为主,不同胎龄、不同出生体质量感染病原菌分布有差异性。病原菌对常见抗菌药物的敏感性较低,临床上应规范使用抗菌药物,减少耐药株的产生。ObjectiveThe distribution and drug resistance of pathogenic bacteria in neonatal bloodstream infections were analyzed in Kaifeng city.Methods The clinical data of 212 cases of neonatal bloodstream infection admitted to the Department of Neonatology in our hospital were retrospective analyzed.The basic information on the children participating were collected.The newborns grouped based on their gestational age and birth weight.The venous blood of children were collected,and then cultured with an automatic blood culture instrument.After cultivation and purification,the pathogen were identified by fully automatic bacterial identification instrument.The antimicrobial susceptibility testing on major pathogenic bacteria were conducted by Kirby Bauer paper diffusion method.Results A total of 212 pathogenic bacteria were detected,including 125 Gram positive bacteria(58.96%),67 Gram negative bacteria(31.61%),and 20 fungi(9.43%).The main Gram positive bacteria were Staphylococcus epidermidis(87 strains)and S.aureus(12 strains).Gram negative bacteria were mainly K.pneumoniae(25 strains)and E.coli(13 strains).The main fungus was C.albicans(5.66%).By comparing the distribution of the main pathogens of Neonatal infection at different gestational ages,the constituent ratios of K.pneumoniae,E.coli,C.albicans and C.glabrata were statistically significant(all P<O.05).By comparing the distribution of the main pathogens of Neonatal infection with different birth weight,the constituent ratios of S.epidermidis,S.hominis,K.pneumoniae,A.baumannii and C.albicans were statistically significant(all P<o.05).S.epidermidis and S.aureus were all resistant to penicillin G,and none of them were resistant to linezolid,vancomycin,teicoplanin,and furantoin.K.pneumoniae and E.coli were all resistant to ampicillin,and no Imipenem resistant strains were detected.The resistance rate of fungi to amphotericin B,fluconazole,voriconazole,and itraconazole was relatively low,and no resistant strains to flucytosine have been developed.Conclusion In Kaifeng cit

关 键 词：新生儿血流感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]