摘要
目的 探讨新生儿感染致病菌的流行病学及常见抗菌药物的敏感性。方法 按《全国临床检验操作规程》鉴定细菌 ,纸片扩散法进行药敏试验。结果 12年内分离出病原菌 2 2 44株。病原菌为 :院外感染前 3位是表皮葡萄球菌、腐生葡萄球菌及大肠埃希菌 ;院内感染前 3位是大肠埃希菌、克雷伯菌及绿脓杆菌。多数院内感染菌株较院外感染菌株对青霉素、氨苄青霉素等 15种常用抗生素的耐药率有不同程度的增加 ,部分差异有统计学意义。总敏感率为 :环丙沙星 95 2 %、诺氟沙星78 8% ,阿米卡星 78 2 %、亚胺培南 +西司他丁 87 7%、万古霉素 81 8%、头孢类抗生素尤其是第 3代头孢菌素 6 0 7%～ 78 1%。结论 院外感染致病菌以革兰阳性球菌为主 ,而院内感染致病菌以革兰阴性杆菌为主 ,后者对许多抗菌药物更易产生耐药性 ;环丙沙星、诺氟沙星、阿米卡星、亚胺培南 +西司他丁、万古霉素及头孢类抗生素尤其是第
Objective For neonatal infectious diseases, there are a variety of predominant pathogenic bacteria and antimicrobial sensitive patterns in different regions and different periods. The aim of the present study was to investigate the epidemiological characteristics of bacterial agents and their in vitro antimicrobial susceptibility in our hospital, so as to treat neonatal infections accordingly. Methods Identifications of bacteria were performed by using the method of Manual of Clinical Microbiology. Disk diffusion tests were done for the antimicrobial susceptibility. Results were interpreted according to NCCLS (1999) recommendations. Results From January 1987 to December 1998, 2 244 bacterial strains were isolated from 1 694 neonates. The first three predominant species were Staphylococcus epidermidis (23.9%), Staphylococcus saprophyticus (19.9%) and Escherichia coli (12.6%) in the group Ⅰ neonates (infections acquired outside the hospital). Escherichia coli, Klebsiella and Pseudomonas aeruginosa accounted for 18%, 15 2% and 12.6%, respectively, in the group Ⅱ neonates (nosocomial infections). Most strains from the group Ⅱ presented higher resistant rates to penicillin and ampicillin and so on than those from the group Ⅰ. There were significant increases in the resistance of penicillin to Klebsiella, ampicillin to Escherichia coli,oxacillin to Staphylococcus epidermidis, cefazoline to Staphylococcus saprophyticus, cefaperazole to Escherichia coli, gentamycin to Staphylococcus aureus and Staphylococcus saprophyticus, and kanamycin to Escherichia coli. The sensitive rates were as follows: cyprofloxacin 95.2%, norfloxicin 78.8%, amikacin 78.2%, tienam 87.7%, vancomycin 81.8%, and cephalosporins especially the third generation 60.7%～78.1%. Conclusions Gram negative bacteria were mainly responsible for nosocomial infections of neonates in our hospital but Gram positive bacteria mainly caused infections acquired outside the hospital. The nosocomial pathogens tended to produce drug resistance. Cyprofloxacin, norfloxacin, amikacin, tienam, vancomycin and the third generation cephalosporins were revealed with higher sensitivity rates to pathogenic bacteria in newborns.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2001年第6期354-357,共4页
Chinese Journal of Pediatrics
