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目的探讨新生儿重症监护病房(NICU)患儿感染病原菌分布及耐药性,为临床合理选择抗菌药物提供依据。方法选取2013年9月-2015年9月本院NICU感染患儿260例,采集患儿血液、痰液等标本进行病原菌培养、分离检测和药物敏感试验,分析病原菌分布及其耐药性。结果 260例患儿共分离病原菌274株,其中革兰阴性菌176株(64.2%),革兰阳性菌86株(31.4%),真菌12株(4.4%)。革兰阴性菌对第三代头孢菌素、喹诺酮、氨基糖苷类等抗菌药物耐药率较高,多数>70%;耐药率较低的是亚胺培南、头孢哌酮/舒巴坦、哌拉西林/舒巴坦等;革兰阳性菌对青霉素、克林霉素、红霉素、氨苄西林和左氧氟沙星等抗菌药物耐药率较高,多数>70%,未发现对万古霉素耐药菌;真菌的耐药率较低,均未表现出对伊曲康唑、制霉菌素和氟康唑等药物耐药。结论 NICU患儿感染病原菌以革兰阴性菌为主,耐药情况较为严重,临床用药应该避免经验性用药,及时做细菌培养和药敏试验,根据药敏结果进行针对性选择用药,避免抗菌药物的滥用。
Objective To investigate the distribution and drug resistance of pathogenic bacteria in neonatal intensive care unit (NICU) patients and provide basis for clinical rational selection of antimicrobial agents. Methods From September 2013 to September 2015,260 cases of NICU infection in our hospital were collected. Samples of blood and sputum from children were collected for pathogen culture, separation and drug susceptibility testing, and the distribution and drug resistance of pathogens were analyzed. Results A total of 274 strains of pathogens were isolated from 260 children, including 176 Gram-negative bacteria (64.2%), 86 Gram-positive bacteria (31.4%) and 12 fungi (4.4%). Gram-negative bacteria had the highest resistance rate to the third-generation cephalosporins, quinolones, aminoglycosides and other antibacterials, mostly> 70%. The lower rates of resistance were imipenem, cefoperazone / sulbactam , Piperacillin / sulbactam and so on; Gram-positive bacteria resistant to penicillin, clindamycin, erythromycin, ampicillin and levofloxacin and other antimicrobial resistance was high, most> 70%, found no vancomycin Resistant bacteria; fungal resistance rate is low, did not show the itraconazole, nystatin and fluconazole and other drugs resistant. Conclusion The main pathogens in NICU are Gram-negative bacteria. The drug resistance is more serious. Clinical medication should be avoided by empirical medication. Bacterial culture and drug susceptibility test should be done in time. According to drug susceptibility results, Abuse.