社区获得性重症肺炎新生儿临床病原菌分布情况及耐药性分析  

Analysis of Clinical Pathogens and Drug Resistance in Newborns with Community-Acquired Severe Pneumonia from 2021 to 2023

作　　者：于宝磊 YU Baolei(Department of Laboratory,Zibo Maternal and Child Health Hospital,Zibo,Shandong 255000,China)

机构地区：[1]淄博市妇幼保健院检验科,山东淄博255000

出　　处：《中国医药指南》2025年第5期141-143,共3页Guide of China Medicine

摘　　要：目的探讨社区获得性重症肺炎新生儿血培养病原菌分布情况及耐药性。方法选取2021年1月至2023年12月淄博市妇幼保健院社区获得性重症肺炎新生儿血培养的临床资料,统计分析血培养分离病原菌的种类,并对病原菌分布情况及耐药特点进行分析。结果120例患儿,通过血培养共检出病原菌99株(82.50%),其中41株(41.41%)为革兰阴性菌,常见的为大肠埃希菌17株(17.17%)及阴沟肠杆菌9株(9.09%);56株(56.57%)为革兰阳性菌,常见的为表皮葡萄球菌(34株,34.34%)及人葡萄球菌(9株,9.09%);真菌2株,均为白色念珠菌。药敏检测结果显示,氨苄西林对主要革兰阴性菌的耐药性较高,尤其是大肠埃希菌、阴沟肠杆菌,均超过80%,甚至达到100%,对头孢二代和三代药物的耐药性也较高,但对头孢三代抗生素(氨苄西林/舒巴坦)、碳青霉烯类抗生素(美罗培南、亚胺培南)、氨基糖苷类抗生素(阿米卡星、庆大霉素)等敏感性较高,达到100%,对氨基糖苷类抗生素(妥布霉素)的敏感性也较高,尤其是阴沟肠杆菌,敏感性达到100%;主要革兰阳性菌对青霉素类和大环内酯类(红霉a素)耐药性极高,达到88.24%及76.27%,已不建议使用,而对复方新诺明较高,达到50%,但对糖肽类抗生素(万古霉素)、恶唑烷酮类抗生素(利奈唑胺)及氨基糖苷类抗生素(妥布霉素)的敏感性较高,达100%。结论社区获得性重症肺炎新生儿以革兰阳性菌感染为主,常见的病原菌有表皮葡萄球菌、大肠杆菌、阴沟肠杆菌及人葡萄球菌为主,其对多种抗生素存在不同程度耐药情况,临床可根据药敏试验结果采取对症治疗措施,合理用药。Objective To investigate the distribution and drug resistance of pathogenic bacteria in blood culture of newborns with community-acquired severe pneumonia.Methods The clinical data of blood culture of newborns with community-acquired severe pneumonia in Zibo Maternal and Child Health Hospital from January 2021 to December 2023 were retrospectively analyzed,the types of pathogenic bacteria isolated from blood culture were statistically analyzed,and the distribution and drug resistance characteristics of pathogenic bacteria were comprehensively analyzed.Results In 120 children,99 strains(82.50%)were detected by blood culture,of which 41 strains(41.41%)were Gram-negative bacteria,and the common strains were Escherichia coli(17 strains,17.17%)and Enterobacter cloacae(9 strains,9.09%).56 strains(56.57%)were Gram-positive bacteria,and the common strains were Staphylococcus epidermidis(34 strains,34.34%)and Staphylococcus hominis(9 strains,9.09%).There are 2 strains of fungi,all of which are Candida albicans.The results of drug sensitivity test showed that ampicillin was highly resistant to the main gram-negative bacteria,especially Escherichia coli and Enterobacter cloacae,all of which exceeded 80%or even reached 100%,and was also highly resistant to the second and third generation cephalosporins,but it was highly resistant to the third generation cephalosporins(ampicillin/sulbactam),carbapenems(meropenem,imipenem)and aminoglycosides(aminoglycosides).The drug resistance of main Gram-positive bacteria to penicillins and macrolides(erythromycin)is extremely high,reaching 88.24%and 76.27%,so it is no longer recommended to use them,but it is higher to compound sulfamethoxazole,reaching 50%,but it is more sensitive to glycopeptide antibiotics(vancomycin),oxazolidinone antibiotics(linezolid)and aminoglycoside antibiotics(tobramycin),reaching 100%.Conclusions Neonates with severe community-acquired pneumonia are mainly infected by Gram-positive bacteria,and the common pathogens are Staphylococcus epidermidis,Escherichia coli,

关 键 词：社区获得性重症肺炎 新生儿 血培养 病原菌 耐药性 合理用药 

分 类 号：R725.6[医药卫生—儿科] R563.1[医药卫生—临床医学]