摘要
目的观察新生儿重症监护病房(NICU)患儿感染病原菌分布特点及分析耐药性,为临床合理选择抗菌药物提供依据。方法对2012年3月-2014年3月156例新生儿败血症患儿血液进行病原菌分离、培养鉴定,采用K-B纸片法进行药敏试验分析。结果 156例新生儿败血症患儿血液样本中共分离培养出病原菌165株,其中以革兰阳性菌为主,占61.8%,明显高于革兰阴性菌的32.7%和真菌的5.5%,差异有统计学意义(P<0.05);以凝固酶阴性葡萄球菌、肺炎克雷伯菌和白色假丝酵母菌为主分别占40.0%、13.3%和4.2%;凝固酶阴性葡萄球菌对青霉素G、氨苄西林、克林霉素和罗红霉素的耐药率较高,达80.0%以上,未发现对万古霉素耐药菌,肺炎克雷伯菌对氨苄西林、头孢他啶和头孢曲松表现出较高的耐药率,耐药率均在80.0%以上,而对环丙沙星、培氟沙星和氯霉素的耐药率在30.0%以下,未发现对亚胺培南耐药菌,9株真菌均未表现出对伊曲康唑、制霉菌素、两性霉素B和氟康唑耐药。结论新生儿重症监护病房的患儿感染以革兰阳性菌为主,耐药现象较为严重,应引起临床医师的重视。
OBJECTIVE To observe the distribution and drug resistance of pathogens causing infections in the chil-dren of neonatal intensive care unit （NICU ） so as to provide guidance for reasonable clinical use of antibiotics . METHODS A total of 156 children with septicemia who were treated in the NICU from Mar 2012 to Mar 2014 were enrolled in the study ,then the blood specimens were collected for the isolation ,culture ,and identification of pathogens ,and the drug susceptibility testing was performed with the use of K-B disk method .RESULTS Totally 165 strains of pathogens were cultured from the blood specimens that were obtained from the 156 children with septicemia ,of which 61 .8% were the gram-positive bacteria ,32 .7% were the gram-negative bacteria ,and 5 .5%were the fungi ,and there was significant difference （P〈 0 .05） ;the coagulase-negative Staphylococcus ,K lebsiel-la pneumoniae ,and Candida albicans were the predominant species of pathogens ,accounting for 40 .0% ,13 .3% , and 4 .2% ,respectively .The drug resistance rates of the coagulase-negative Staphylococcus to penicillin G ,ampi-cillin ,clindamycin ,and roxithromycin were more than 80 .0% ;no strain resistant to vancomycin was found .The drug resistance rates of the K .pneumoniae to ampicillin ,ceftazidime ,and ceftriaxone were more than 80 .0% ,the drug resistance rates to ciprofloxacin ,pefloxacin ,and chloramphenicol were less than 30 .0% ,and no strain re-sistant to imipenem was found .The 9 strains of fungi were not resistant to itraconazole ,nystatin ,amphotericin , or fluconazole .CONCLUSION The gram-positive bacteria are dominant among the pathogens causing infections in the children of NICU and are highly drug-resistant ,to which the clinician should pay high attention to .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第6期1276-1277,1280,共3页
Chinese Journal of Nosocomiology
基金
河南省科技厅重点基金资助项目(201401023)
关键词
新生儿重症监护病房
病原菌
分布
药敏试验
Neonatal intensive care unit
Pathogen
Distribution
Drug susceptibility testing
