摘要
目的:了解嘉兴地区近年来新生儿感染性肺炎病原菌构成比及耐药性,为临床正确诊断、合理使用抗生素、避免抗生素滥用提供依据。方法对嘉兴地区诊断为感染性新生儿肺炎3025例进行无菌取痰,进行细菌培养及耐药性分析。结果共分离出菌株1156例,其中革兰阴性菌875例(75.7%),革兰阳性菌269例(23.3%),真菌12例(1.0%)。革兰阴性菌以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、阴沟肠杆菌常见(肺炎克雷伯菌178例,大肠埃希菌151例,鲍曼不动杆菌87例,阴沟肠杆菌113例),革兰阳性菌以金黄色葡萄球菌最多见(金黄色葡萄球菌245例)。革兰阴性菌对头孢唑啉、氨苄西林、哌拉西林耐药严重,对美罗培南、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦较敏感。 ESBL阳性菌耐药性严重。金黄色葡萄球菌对青霉素、氨苄西林、红霉素、克林霉素耐药严重,对力奈唑脘、万古霉素、呋喃妥因等敏感。结论新生儿感染性肺炎以革兰阴性菌为主,且耐药性严重。规范管理,及早隔离,加强病原菌检测,合理使用抗生素,可减少耐药菌的产生。
Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia in Jiaxing,and to provide a therapy for clinical doctor to make a correct diagnosis,choose reasonable anti-biotics and avoid abuse of antibiotics.Methods Took expectoration from trachea in condition of asepsis to conduct culture and perform drug-sensitive test from 3025 cases.Results Totally 1 156 strains of aerobic bacteria were iso-lated.875 strains were gram negative bacilli(75.7%),269 strains were gram positive cocci(23.3%),and 12 strains were fungi(1.0%).Klebsiella pneumoiae,Escherichia coil,Acinetobacter baumanni,Enterobacter cloacae were com-mon in gram negative bacilli( respectively 178 cases,151 cases,87 cases,113 cases) .The proportion of the Staphylo-coccus aureus was the largest in gram positive cocci(245 cases) .The results showed that gram-negative bacilli were resistant to cefazolin, ampicillin, piperacillin and sensitive to meropenem, imipenem, piperacillin-tazuobatanna and cefoperazone-sulbactam.The drug resistance was severe of ESBL-positive.Staphylococcus aureus was resistant to penicillin, ampicillin, erythrocin, clindamycin and sensitive to linezolid, vancomycin, nitrofurantoin.Conclusion Gram-negative bacilli are the main bacteria in neonatals with infectious pneumonia.The drug resistance is severe.It is important to make a standard management and isolation.
出处
《中国基层医药》
CAS
2016年第8期1136-1140,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省嘉兴市科技局项目(2012AY1071.12)
关键词
新生儿肺炎
细菌
耐药性
Neonatal pneumonia
Bacteria
Drug resistance