摘要
目的:调查274例新生儿败血症病原菌分布及耐药情况,以指导临床合理用药。方法:回顾性分析274例败血症新生儿的临床资料,采取病例对照研究法,根据不同发病时间,分为早发型败血症98例、晚发型败血症176例,研究病原菌分布及耐药性。结果:败血症患儿的血标本病原菌培养为单一致病菌,主要为革兰阳性球菌、革兰阴性杆菌、真菌,分别是154株(56.2%),114株(41.6%),6株(2.2%);早发型败血症病原菌主要是革兰阴性菌(57.1%);晚发型败血症病原菌主要是革兰阳性菌(64.2%);早发型新生儿败血症凝固酶阴性葡萄球菌、表皮葡萄球菌感染比例明显低于晚发型新生儿败血症(P<0.05),晚发型新生儿败血症大肠埃希菌感染比例明显低于早发型新生儿败血症(P<0.05)。革兰阳性菌中,金黄色葡萄球菌、凝固酶阴性葡萄球菌、表皮葡萄球菌,对万古霉素的敏感性最高,对青霉素G敏感率最低;革兰阴性菌中,大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对美罗培南、亚胺培南的敏感性最高。结论:新生儿早发型、晚发型败血症常见病原菌不同,临床在治疗时应根据细菌鉴定、药敏试验结果合理选择抗生素药物,并注意监测耐药性。
Objective: To investigate the distribution and drug resistance of 274 cases of neonatal sepsis pathogens and their related in order to guide the rational use of drugs, and to analyze the distribution and drug resistance of pathogens through data collection.Methods: The clinical data and clinical data of 274 children with neonatal sepsis were retrospectively analyzed. A case-control study was conducted. According to different time of onset, 98 cases of early onset sepsis and 176 cases of late onset sepsis were included analysis of pathogen distribution and drug resistance. Results:The blood specimens of children with neonatal sepsis were cultured with single pathogens, mainly Gram-positive cocci, Gram-negative bacilli and fungi, which were 154(56.2%) and 114(41.6%), respectively. 6 strains(2.2%);early-type sepsis pathogens were mainly Gram-negative bacteria(57.1%);late-type sepsis pathogens were mainly Gram-positive bacteria(64.2%);early-onset neonatal sepsis coagulase-negative staphylococci, epidermal grapes.The proportion of cocci infection was significantly lower than that of late-onset neonatal sepsis(P<0.05). The proportion of Escherichia coli infection in late-onset neonatal sepsis was significantly lower than that in early-onset neonatal sepsis(P<0.05). The sensitivity of Gram-positive bacteria to antibiotics Among Gram-positive bacteria, Staphylococcus aureus, coagulase-negative staphylococci, and Staphylococcus epidermidis have the highest sensitivity to vancomycin and the lowest sensitivity to penicillin G;sensitivity of Gram-negative bacteria to commonly used antibacterial drugs: Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae have the highest sensitivity to meropenem and imipenem, and the main gram-negative bacteria are commonly used for antibacterial Case-sensitive material. Conclusion: The common pathogens of early-onset and late-onset sepsis in neonates are different. Clinicians should choose antibiotics according to the results of bacterial identification and drug susceptibility test, and pay attention to monitoring drug resistance.
作者
杨蓉
YANG Rong(Neonatology Department of Baoji Maternal and Child Health Hospital,Baoji 721000)
出处
《陕西医学杂志》
CAS
2019年第8期1098-1101,共4页
Shaanxi Medical Journal
基金
陕西省卫生科学研究基金资助项目(2012K1018)
关键词
新生儿
败血症
病原菌分布
耐药性
药敏试验
抗生素
Neonatal
Sepsis
Pathogen distribution
Drug resistance analysis
Drug sensitivity test
Antibiotics
