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目的探讨新生儿重症监护室(NICU)多重耐药菌的种类并评估多重耐药菌药敏试验的结果在临床选用抗生素的意义,以指导临床合理用药。方法对我院NICU2010年1月-2010年12月60例新生儿下呼吸道痰培养结果为多重耐药菌的病例进行分析。观察多重耐药菌种类,对耐药菌根据患儿的临床症状、胸片、血常规、CRP、I/T值、血沉等结果综合评估患儿是否需要更改抗生素,更改为未更改抗生素组和更改抗生素组,比较两组的住院时间、住院费用、插管时间及肝肾功能损害。结果新生儿重症监护室多重耐药菌以肺炎克雷伯菌、鲍曼不动杆菌、表皮葡萄球菌、大肠埃希菌、铜绿假单胞菌为主。更改抗生素组与未更改抗生素组的住院时间、住院费用、插管时间无统计学意义。肝肾功能损害,P<0.05,差异有统计学意义。结论多重耐药菌呈增多趋势,大肠埃希菌、肺炎克雷伯菌、肠杆菌耐药率在65%以上。对耐药菌的抗生素选用,不能完全根据药敏结果来选药。应根据患儿临床表现及其他实验结果综合评估,以达到给患儿最好治疗效果及愈后。
Objective To investigate the types of multidrug-resistant bacteria (NICU) in neonatal intensive care unit (NICU) and to evaluate the significance of drug susceptibility testing of multi-drug-resistant bacteria in the clinical use of antibiotics in order to guide clinical rational drug use. Methods NICU from January 2010 to December 2010 in 60 cases of neonatal respiratory tract sputum culture results were analyzed for multiple drug-resistant bacteria. To observe the multi-drug resistant strains, the resistant bacteria were comprehensively evaluated according to the clinical symptoms, chest radiograph, blood routine, CRP, I / T value and ESR in the children to change the antibiotics, The changes of antibiotics group, hospitalization time, hospitalization costs, intubation time and liver and kidney dysfunction were compared between the two groups. Results The multidrug-resistant bacteria in neonatal intensive care unit were Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa. There was no significant difference in hospitalization time, hospitalization cost and intubation time between antibiotic group and non-antibiotic group. Liver and kidney dysfunction, P <0.05, the difference was statistically significant. Conclusion The multi-resistant strains showed an increasing trend. The rates of Escherichia coli, Klebsiella pneumoniae and Enterobacter were above 65%. Antibiotic antibiotic use, can not be completely based on drug susceptibility results to medicine. Should be based on the clinical manifestations of children and other experimental results comprehensive assessment, in order to achieve the best treatment for children and prognosis.