摘要
目的分析新生儿重症监护病房(NICU)新生儿感染病原菌、耐药性及其影响因素。方法选取2017年5月-2020年5月新乡市中心医院NICU收治的疑患感染性疾病新生儿100例(感染组)及同期非感染新生儿125例(非感染组),对感染组患儿血液、痰等标本进行细菌培养与分离,分析病原菌与耐药性,比较两组新生儿性别、胎龄、出生体质量、羊水污染情况,新生儿窒息等临床资料,归纳NICU新生儿感染的影响因素。结果100例NICU感染新生儿共检出病原菌130株,主要分离自气管(53.00%)、血液(13.00%)、尿液(11.00%);其中革兰阴性菌83株占63.85%,革兰阳性菌42株占32.31%、真菌5株占3.85%,以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、肺炎链球菌和金黄色葡萄球菌为主;主要革兰阴性菌对对氨苄西林、头孢唑林耐药率较高(>70%),主要革兰阳性菌对左氧氟沙星、克林霉素、红霉素、青霉素耐药率较高(>70%),未发现对万古霉素耐药的肺炎链球菌;胎龄、出生体质量、住院时间、接受机械通气、深静脉置管、联合使用抗菌药物、抗菌药物使用时间是NICU新生儿感染的影响因素(P<0.05)。结论NICU新生儿感染病原菌以革兰阴性菌为主,且胎龄、出生体质量、住院时间、接受机械通气、深静脉置管、联合使用抗菌药物、抗菌药物使用时间为感染的影响因素,应加强监控。
OBJECTIVE To analyze the neonatal pathogens,drug resistance of infection in the neonatal intensive care unit(NICU)and its influencing factors.METHODS From May 2017 to May 2020,100 neonates with suspected infectious diseases(infected group)and 125 uninfected neonates(uninfected group)admitted to NICU of Xinxiang Central Hospital were selected in the study.Blood and sputum samples were collected from the infection group for bacteria culture and isolation,pathogenic bacteria and drug resistance were analyzed,the gender,gestational age,birth weight,amniotic fluid contamination,neonatal asphyxia and other clinical data of newborns in the two groups were compared,and influencing factors of infections in NICU were summarized.RESULTS A total of 130 strains of pathogenic bacteria were detected in 100 infected neonates in NICU,which were mainly from the trachea(53.00%),blood(13.00%)and urine(11.00%).There were 83 strains of Gram-negative bacteria accounting for 63.85%,42 strains of Gram-positive bacteria accounting for 32.31%and 5 strains of fungi accounting for 3.85%,dominating with Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,and Streptococcus pneumoniae.The resistance rates of main Gram-negative bacteria to ampicillin,ceftriaxone,ceftazidime and cefazolin were high(>70%),and the resistance rates of main Gram-positive bacteria to levofloxacin,clindamycin,erythromycin and penicillin were high(>70%).No vancomycin-resistant S.pneumoniae was found.Gestational age,birth weight,length of hospital stay,mechanical ventilation,deep vein catheterization,combined use of antimicrobial drugs and use time of antimicrobial drugs were influencing factors of neonatal infections in NICU(P<0.05).CONCLUSION Gram-negative bacteria were the main pathogenic bacteria of infections in NICU,with serious drug resistance.Gestational age,birth weight,hospital stay,mechanical ventilation,deep vein catheterization,combined use of antibacterial drugs and use time of antibacterial drugs were the influencing factors of infections,which should be monitored strictly.
作者
原超
邢二庆
刘倩
王园秀
沈洁
张卫星
YUAN Chao;XING Er-qing;LIU Qian;WANG Yuan-xiu;SHEN Jie;ZHANG Wei-xing(Xinciang Central Hospital,Xinxiang,Henan 453000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第12期1822-1826,共5页
Chinese Journal of Nosocomiology
基金
河南省科研基金资助项目(2018126)。
关键词
新生儿重症监护病房
新生儿
病原菌
耐药性
影响因素
Neonatal intensive care unit
Neonate
Pathogenic bacteria
Drug resistance
Influencing factor
