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目的:了解南京地区新生儿败血症病原菌分布及其耐药情况,为临床合理选择抗生素提供参考。方法:收集2009年1月-2011年9月我院住院新生儿血培养标本1546例,分析其病原菌分布及耐药性。结果:1546例新生儿血培养标本共检出细菌186株,总阳性率为12.03%,因无临床表现支持而被视为假菌血症者7例,污染率为3.76%(7/186)。其中革兰阳性菌129株,占总分离菌的72.07%,革兰阳性菌以凝固酶阴性葡萄球菌为主,占革兰阳性菌的76.74%,占总分离菌的55.31%;革兰阴性菌50株,占总分离菌的27.93%,革兰阴性菌以肺炎克雷伯菌居多,占革兰阴性菌的42.00%,占总分离菌的11.73%。革兰阳性菌对抗生素耐药率最高的为青霉素,其次为红霉素,对万古霉素、哌拉西林/他唑巴坦、阿米卡星以及左氧氟沙星表现了较低的耐药率;革兰阴性菌对抗生素耐药率最高的为氨苄西林,其次为哌拉西林、头孢唑林、氨曲南,对亚胺培南、头孢吡肟、阿米卡星、左氧氟沙星以及加酶抑制剂的复合制剂表现了较低的耐药率。结论:凝固酶阴性葡萄球菌是南京地区近2年新生儿败血症最常见的病原菌,其次为肺炎克雷伯菌,对常用抗生素均有不同程度的耐药。
Objective: To understand the distribution and drug resistance of neonatal sepsis in Nanjing and to provide a reference for the rational selection of antibiotics in clinical practice. Methods: A total of 1546 blood samples were collected from January 2009 to September 2011 in our hospital, and the distribution and drug resistance of the pathogens were analyzed. Results: A total of 186 bacterial strains were detected in 1546 neonatal blood culture samples, with a total positive rate of 12.03%. Seven patients were considered as pseudo- bacteremia because of no clinical support. The contamination rate was 3.76% (7/186) . Gram-positive bacteria, of which 129 strains, accounting for 72.07% of the total isolates, Gram-positive bacteria coagulase-negative staphylococci, accounting for 76.74% of gram-positive bacteria, accounting for 55.31% of the total isolates; Gram-negative bacteria 50 strains, accounting for 27.93% of the total isolates. The majority of gram-negative bacteria were Klebsiella pneumoniae, accounting for 42.00% of gram-negative bacteria, accounting for 11.73% of the total isolates. Gram-positive bacteria had the highest rate of antibiotic resistance for penicillin, followed by erythromycin, and vancomycin, piperacillin / tazobactam, amikacin and levofloxacin showed lower resistance rates; leather Ampicillin was the most resistant to antibiotics in the blue-negative bacteria, followed by piperacillin, cefazolin, aztreonam, imipenem, cefepime, amikacin, levofloxacin and enzyme inhibitors The composite showed a lower rate of resistance. Conclusion: Coagulase negative Staphylococcus aureus is the most common pathogen of neonatal sepsis in Nanjing in the recent two years, followed by Klebsiella pneumoniae, with different levels of resistance to commonly used antibiotics.