摘要
目的：探讨近年来宜宾市及周边地区新生儿败血症的病原学及耐药性特点，以期达到对临床诊治和预防的指导。方法通过对365例败血症中167例血培养阳性的新生儿败血症的病原学及耐药性进行回顾性分析。并分析新生儿败血症的病原学变迁及耐药性特点。结果在365例新生儿败血症血培养标本中，阳性病例167例，阳性率为45．75％，其中占首位的致病菌为表皮葡萄球菌58例（占34．73％），其次致病菌依次分别为溶血葡萄球菌29例（占17．37％）、金黄色葡萄球菌22例（占13．17％）、其他球菌占15例（占8．98％），肺炎克雷伯菌感染18例（占10．78％），大肠埃希菌15例（占8．98％），其他革兰阴性细菌感染10例（占5．99％）。表皮葡萄球菌、溶血葡萄球菌感染率明显呈上升趋势。革兰阳性球菌对青霉素、头孢唑啉、苯唑青霉素、头孢西丁的耐药性高；对三代头孢、亚胺培南、美罗培南的耐药性较高，且有增加的趋势；对万古霉素敏感性100．00％。革兰阴性杆菌对氨苄青霉素、头孢唑啉及三代头孢等耐药率高，对亚胺培南、美罗培南高度敏感。结论新生儿败血症的病原菌主要是葡萄球菌，其中最主要是凝固酶阴性的葡萄球菌（Coagulase-Negative Staphylococci CoNS），革兰阳性球菌中表皮葡萄球菌、溶血葡萄球菌上升明显；革兰阴性菌中大肠埃希菌呈上升趋势。新生儿败血症细菌耐药有增高趋势，加强对耐药性的检测显得十分重要。
Objective To study the characteristic of etiology and drug resistance of neonatal sepsis for rational use antibiotics in clinic.Methods The etiology and drug resistance of 167 positive hemoculture examples of 365 neonatal sepsis examples were retrospectively analyzed,and the characteristic of etiology diversify and drug resist-ance characteristic of neonatal sepsis were also analyzed.Results In 365 blood culture examples of neonatal sepsis, there were 167 positive cases,positive ratio was 45.75%.Among pathogenic bacterium,the first etiology was staphylo-coccus epidermidis,there were fifty -eight examples and account of 34.73%.The second was staphylococcus haemo-lyticus and accounts twenty -nine examples and 17.37%.The third was staphylococcus aureus which had twenty -two examples and account 13.17%.The annual infection rate of staphylococcus epidermidis and staphylococcus hae-molyticus in the second five years were increased obviously.Gram -positive coccus drug resistance to penicillin,cep-hazolin,oxazocilline and cefoxitin were very high and the rate of the second five years were higher than that of the first five years.Gram -positive coccus drug resistance to third -generation cephaloporins and imipenem and meropenem were higher than vancocin and the rate of the second five years were higher than that of the first five years.Gram -positive coccus was 100.00% sensitive to vancomycin.Gram negative bacilli drug resistance rate to penbritin and cep-hazolin and third -generation cephaloporins was the highest.Gram negative bacilli to meropenem and imipenem was hypersensitive in all antibiotics.Conclusion The chief pathogenic bacteria of neonatal septicemia is staphylococci. Among pathogenic bacterium,the main pathogenic bacteria is CoNS,and staphylococcus epidermidis and staphylococ-cus haemolyticus goes up significantly.Among gram -negative bacilli,the escherichia coli goes up.The drug resist-ance to bacteria goes up in neonatal sepsis,it is very important to monitor the drug resistance.
出处
《中国基层医药》
CAS
2015年第18期2770-2773,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
婴儿
新生
败血症
病原学
耐药性
Infant,Newborn
Epticemia
Etiology
Drug resistance
