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目的:分析新生儿败血症的病原菌及药敏情况以指导临床用药。方法:回顾性分析2010年9月至2012年9月岳阳市妇女儿童医院收治的50例新生儿败血症患儿的临床表现、辅助检查、病原菌及药敏情况。结果:50例新生儿败血症病原菌中,革兰阳性菌占66.0%(33/50),凝固酶阴性葡萄球菌占44.0%(22/50),革兰阳性菌对利福平、夫西地酸、万古霉素敏感率高(76.0%～100%),对青霉素、苯唑西林及红霉素敏感率较低(9.0%～12.0%);革兰阴性菌占34.0%(17/50),以铜绿假单胞菌(5例,10.0%)、肺炎克雷伯菌(4例,8.0%)为主,对哌拉西林/他唑巴坦、美罗培南敏感率高(88.2%～94.1%),对氨苄西林敏感率低(6.0%)。结论:新生儿败血症临床症状、体征不典型,尽早行血培养明确病原菌并根据药敏结果选用合适的抗生素是治疗成功的关键。
Objective: To analyze the pathogens and drug susceptibility of neonatal sepsis to guide the clinical medication. Methods: The clinical manifestations, laboratory tests, pathogens and drug susceptibility of 50 neonates with sepsis were retrospectively analyzed from September 2010 to September 2012 in Yueyang Women and Children’s Hospital. Results: Gram-positive bacteria accounted for 66.0% (33/50) and coagulase-negative staphylococci accounted for 44.0% (22/50) in 50 neonatal sepsis pathogens. Gram-positive bacteria were sensitive to rifampin, fusidic acid , Vancomycin (76.0% ~ 100%), penicillin, oxacillin and erythromycin (9.0% ~ 12.0%), Gram-negative bacteria accounted for 34.0% (17/50) Pseudomonas aeruginosa (5 cases, 10.0%) and Klebsiella pneumoniae (4 cases, 8.0%) were the most sensitive to piperacillin / tazobactam and meropenem (88.2% -94.1% ), Low susceptibility to ampicillin (6.0%). Conclusion: Neonatal sepsis clinical symptoms and signs are not typical, as early as possible blood culture clear pathogens and drug selection based on susceptibility results appropriate antibiotics is the key to the success of treatment.