2018 年第 7 期 第 13 卷

兰州地区334例新生儿败血症病原菌分布及耐药性分析

作者：马永德刘慧萍

英文作者：Pathogen distribution and drug resistance analysis in 334 cases of neonatal septicemia in Lanzhou district

单位：730050兰州军区兰州总医院儿科

英文单位：

关键词：新生儿败血症；病原菌；耐药性

英文关键词：

• 摘要：

• 【摘要】目的    探讨兰州地区新生儿败血症病原菌分布及药敏特点，为本地区抗菌药物使用提供参考依据。方法    收集2011年1月1日至2016年12月31日在解放军兰州总医院住院期间确诊的334例新生儿败血症的病历资料，所有患儿静脉血中共分离出341株病原菌，分析患儿病原菌分布和药敏特点。结果    341株病原菌中革兰阳性菌185株，以表皮葡萄球菌、溶血葡萄球菌、金黄色葡萄球菌为主；革兰阴性菌104株，以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主；真菌52株，以白色假丝酵母菌、光滑假丝酵母菌为主。葡萄球菌对青霉素类、头孢菌素类、红霉素类抗菌药物的耐药率较高；对喹诺酮类抗菌药物耐药率较低；对万古霉素、替考拉宁、利奈唑胺、米诺环素全部敏感。大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对氨苄西林几乎全部耐药；对头孢西丁、头孢呋辛、头孢曲松、头孢他啶、环丙沙星等耐药率较低；对碳青霉烯类抗菌药物全部敏感。结论    兰州地区新生儿败血症病原菌主要为凝固酶阴性葡萄球菌；主要病原菌对特殊使用级抗菌药物敏感度较高；未发现耐万古霉素菌株。

• 【Abstract】Objective    To analyze the distribution of pathogenic bacteria and the characteristics of drug sensitivity of neonatal septicemia in Lanzhou district. Methods    Totally 341 strains of pathogens were isolated from 334 cases of neonatal septicemia in Lanzhou Military Region General Hospital from January 1, 2011 to December 31, 2016. Distribution of pathogens and characteristics of drug sensitivity were analyzed. Results    There were 185 strains of gram positive bacteria, most were Staphylococcus epidermidis, Staphylococcus haemolyticus and Staphylococcus aureus; 104 strains of gram negative bacteria were mainly Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa; 52 strains of fungi were mainly Candida albicans and Candida tropicalis. Staphylococci showed high resistance rates to penicillins, cephalosporins, erythromycins and low resistance rate to quinolones; staphylococci was sensitive to vancomycin, teicoplanin, linezolid and minocycline. Most of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were resistant to ampicillin; the resistance rates of cefoxitin, cefuroxime, ceftriaxone, ceftazidime and ciprofloxacin were low; all of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were sensitive to carbopenems. Conclusions    Pathogens of neonatal septicemia in Lanzhou district are mainly coagulase negative staphylococci; the proportion of fungal infection increases. Main pathogens of neonatal septicemia are highly sensitive to antibacterial drugs. No vancomycin-resistant strain is found. 

  【Key words】Neonatal septicemia；Pathogenic bacteria；Drug resistance