摘要
目的探讨新生儿重症监护病房（NICU）院内感染的常见病原菌及耐药情况。方法回顾性分析2010年4月～2013年2月人住本院NICU的816例患儿的临床资料，采集相应标本，分离病原菌，分析发生感染的危险因素、药物敏感性及耐药情况。结果55例患儿发生感染，感染发生率为6．74％；感染的危险因素包括胎龄小、体质量轻、住院时间长、接受侵入性操作多、有病原菌定植；分离的514株病原菌中，革兰氏阴性菌362株（70．43％），革兰氏阳性菌122株（23．73％），真菌30株（5．84％）；革兰氏阴性菌主要为肺炎克雷伯菌（181株）、大肠埃希菌（105株）、鲍曼不动杆菌（36株）、铜绿假单胞菌（23株）；革兰氏阳性菌主要为葡萄球菌（73株）、肺炎链球菌（27株）、肠球菌（12株）；真菌全为念珠菌。革兰氏阴性菌对亚胺培南敏感，对三代头孢等耐药率较高；革兰氏阳性菌对万古霉素敏感，对青霉素类耐药率较高。结论NICU中应重点注意胎龄小、体质量轻、住院时间长、有病原菌定植的患儿，慎用侵入性操作；同时加强耐药监测，合理使用有效抗菌药物以降低感染发生率、提高感染治愈率。
Objective To investigate the common pathogens of nosocomial infection in the neonatal intensive care unit （NICU） and their drug resistance situation. Methods The alinical date of 816 children treated in the NICU of our hospital from April 2010 to February 2013 were analyzed retrospetively.Relevant samples were collected and the pathogens were seperated.The risk factors for infection,drug sensitivity and drug resistance were analyzed. Results Infection occurred in 55 children,with the infection incidence of 6.74%;The infection risk factors included small gestational age,small weight,long hospital stay,frequent acceptance of invasive procedures and pathogen colonization;Of the 514 strains of seperated pathogens,362 strains （70.43%） were gram-negative bacteria,122 strains （23.73%） were gram- positive bacteria and 30 strains （5.84%） were fungi;gram-negative bacteria were mainly Kle b s iella p ne umoniae （181 strains）, Escherichia coli （105 strains）,Acinetobacter baumannii （36 strains） and Pseudomonas aeruginosa （23 strains）;gram-positive bacteria were mainly Staphylococcus （73 strains）,Streptococcus pneumoniae （27 strains） and Enterococcus （12 strains）; All fungi were Candida.gram-negative bacteria were sensitive to imipenem and highly drug-resistant to third-generation cephalosporins;gram-positive bacteria were sensitive to vancomycin and highly drug-resistant to penicillin. Conclusion In the NICU,extra attention should be paid to children with small gestational age,small weight,long hospital stay and pathogen colonization and invasive procedures should be used with caution;Meanwhile,strengthen the monitoring of drug resistance and use the antibacterial drugs rationally to reduce the incidence of infection and improve the infection cure rate.
出处
《中国当代医药》
2013年第34期176-177,180,共3页
China Modern Medicine
