新生儿黏质沙雷菌感染/定植17例临床特征及药物敏感试验分析  

Analysis of clinical characteristics and drug resistance of 17 cases of serratia marcescens infection/colonization in neonates

作　　者：刘锦 王俪超 崔红[1] LIU Jin;WANG Li-chao;CUI Hong(Department of Pediatrics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院儿科,北京100050

出　　处：《临床和实验医学杂志》2024年第16期1753-1756,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨新生儿黏质沙雷菌感染或定植的临床特征及药物敏感试验情况。方法选择2013年1月至2022年12月首都医科大学附属北京友谊医院新生儿病房收治的临床标本黏质沙雷菌培养阳性的新生儿进行回顾性分析,分析其临床特征和药物敏感试验结果。结果研究期间共收治黏质沙雷菌培养阳性的新生儿17例,男性12例,女性5例;胎龄37.7±3.2周,早产儿3例,低出生体重儿2例,出生体重(3067±794)g;脐分泌物培养阳性8例(均为新生儿脐炎),痰培养阳性9例(呼吸道定植6例,新生儿肺炎3例),血培养阳性1例(同时痰培养也为阳性)。黏质沙雷菌首次培养阳性的平均日龄为(9.5±7.5)d,培养阳性的住院时间中位数为0 d(0~30 d);17例中有11例为社区来源,包括新生儿脐炎7例,呼吸道定植3例,新生儿肺炎1例。近10年医院黏质沙雷菌分离株均对阿莫西林及第一、二代头孢菌素耐药,对第三代头孢菌素、阿米卡星、厄他培南、左氧氟沙星等敏感。结论黏质沙雷菌不仅是新生儿病房医院感染的主要病原体之一,也见于社区感染或定植,并成为新生儿病房的潜在感染来源,临床医护人员应加强对黏质沙雷菌的认识,定期进行系统的定植菌监测,及时发现定植的致病菌,遏制黏质沙雷菌的传播。Objective To study the clinical characteristics and drug resistance profile of neonatal serratia marcescens infection/colonization.Methods The clinical characteristics and drug resistance profile of serratia marcescens culture positive neonates in neonatal ward of Beijing Friendship Hospital,Capital Medical University from January 2013 to December 2022 were retrospectively analyzed.Results A total of 17 neonates were included in this study,including 5 females and 12 males.The gestational age was(37.7±3.2)weeks and the birth weight was(3067±794)g.There were 3 premature infants and 2 low birth weight infants.The positive specimens included umbilical secretions(8 cases,neonatal omphalitis),sputum(9 cases,including 6 cases of colonization and 3 cases of neonatal pneumonia),and blood(1 case,with sputum also positive).Of the 17 cases,11 were community-derived,including 7 cases of omphalitis,3 cases of respiratory colonization,and 1 case of neonatal pneumonia.Serratia marcescens isolates in this study were resistant to amoxicillin and the first and second generation cephalosporin,and sensitive to the third generation cephalosporin,amicacin,ertabenem,levofloxacin,etc.Conclusion Serratia marcescens is not only one of the main pathogens of nosocomial infection in neonatal ward,but also leads to community infection or colonization.Clinical medical staff should strengthen the understanding of serratia marcescens,and regularly and systematically monitor the colonized bacteria in neonatal ward.

关 键 词：新生儿 黏质沙雷菌 临床特征 药物敏感试验 

分 类 号：R446.5[医药卫生—诊断学] R722.1[医药卫生—临床医学]