569株新生儿感染病原菌分布及耐药分析  

Distribution and drug resistance analysis of 569 neonatal infection pathogens

作　　者：杨琴 李红梅[1] 黄珂 蔡莹 石国民 高利臣 Yang Qin;Li Hongmei;Huang Ke;Cai Ying;Shi Guomin;Gao Lichen(Department of Neonatology,The Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha 410004,China;Department of Clinical Laboratory,The Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha 410004,China;Department of Pharmacy,Changsha Central Hospital Affiliated to University of South China,School of Pharmacy,University of South China,Changsha 410004,China)

机构地区：[1]南华大学附属长沙中心医院新生儿科,长沙410004 [2]南华大学附属长沙中心医院检验科,长沙410004 [3]南华大学附属长沙中心医院药学部,南华大学药学院,长沙410004

出　　处：《中国医师杂志》2024年第12期1778-1783,共6页Journal of Chinese Physician

基　　金：湖南省自然科学基金项目(2024JJ9501)。

摘　　要：目的回顾性分析新生儿感染病原菌分布及其耐药情况,旨在为临床合理使用抗生素提供依据。方法收集2020年1月至2024年6月南华大学附属长沙中心医院新生儿重症监护室(NICU)497例新生儿的感染病原菌,并进行病原菌鉴定和药敏实验。结果共检出569株病原菌,革兰阳性菌195株,占34.27%;革兰阴性菌332株,占58.35%;真菌42株,占7.38%。革兰阳性菌中居前3位的细菌为:凝固酶阴性葡萄球菌63株(11.07%)、表皮葡萄球菌44株(7.73%)、金黄色葡萄球菌18株(3.16%),对利奈唑胺、万古霉素、替加环素、利福平、阿米卡星均敏感(83.33%~100.00%);革兰阴性菌检出率居前三位的分别是:肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌,其中肺炎克雷伯菌对青霉素类、头孢类抗生素的耐药率73.33%~95.00%,大肠埃希菌对复方新诺明耐药菌最高(71.88%),鲍曼不动杆菌对头孢西丁和头孢噻肟耐药率均达到70.00%以上;检出的真菌对两性霉素、5-氟胞嘧啶、伏立康唑、伊曲康唑、氟康唑敏感率均达到80.00%以上。结论本院NICU检测出的病原菌种类较多,以革兰阴性菌为主,对青霉素类、头孢类抗生素的耐药率高。ObjectiveTo retrospectively analyze the distribution and drug resistance of pathogenic bacteria in neonatal infection,in order to provide evidence for rational use of antibiotics in clinic.MethodsPathogenic bacteria were collected from 497 newborn patients in the Neonatal Intensive care Unit(NICU)of the Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China from January 2020 to June 2024,and the pathogen identification and drug susceptibility test were conducted.ResultsA total of 569 strains of pathogenic bacteria were detected,including 195 gram-positive strains(34.27%).332 Gram-negative strains(58.35%);There were 42 fungal strains,accounting for 7.38%.The top 3 gram-positive bacteria were:63 strains(11.07%),44 strains(7.73%)of Staphylococcus epidermidis and 18 strains(3.16%)of Staphylococcus aureus,all of which were sensitive to linezolid,vancomycin,tigecycline,rifampicin and amikacin(83.33%-100.00%).The top three gram negative bacteria detection rates were:Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii.Among them,the resistance rate of Klebsiella pneumoniae to penicillins and cephalosporins was 73.33%-95.00%,the resistance rate of Escherichia coli to cotrimoxazole was the highest(71.88%),and the resistance rate of Acinetobacter baumannii to cefoxitine and cefotaxime was over 70.00%.The sensitivity of the detected fungi to amphotericin,5-fluorocytosine,voriconazole,itraconazole and fluconazole were all over 80.00%.ConclusionsThere are many kinds of pathogens detected in NICU in our hospital,mainly gram-negative bacteria,and the resistance rate to penicillin and cephalosporin antibiotics is high.

关 键 词：感染 婴儿 新生 病原菌 抗药性 微生物 

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