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目的分析新生儿感染性肺炎的病原菌构成及耐药情况,为临床合理选用抗生素提供依据。方法对267例临床诊断为新生儿感染性肺炎患儿在无菌操作下喉镜直视声门处取痰液标本,采用Kirby-Bauer法进行细菌培养和耐药性检测。结果 267份标本共培养出细菌131株,阳性率为49.06%,其中革兰阴性菌91株,占69.47%,革兰阳性菌35株,占26.72%,真菌5株,占3.81%。药敏分析显示:革兰阴性杆菌对左氧氟沙星、哌拉西林/他唑巴坦和亚胺培南较敏感,革兰阳性球菌对左氧氟沙星、阿奇霉素、万古霉素较敏感。结论新生儿肺炎的病原菌分布以革兰阴性菌为主,加强病原菌检测和细菌耐药性分析,对新生儿科临床抗生素的合理应用,减缓耐药菌株的发生有重要意义。
Objective To analyze the constitution and drug resistance of pathogenic bacteria in neonatal infectious pneumonia and provide basis for rational use of antibiotics in clinic. Methods Totally 267 cases of neonates with infectious pneumonia were randomly divided into three groups: sputum samples were taken from the laryngoscope under the auricular line and Kirby-Bauer method was used for bacterial culture and drug resistance test. Results A total of 131 strains of bacteria were cultured in 267 samples, with a positive rate of 49.06%. Among them, 91 were Gram-negative bacteria, accounting for 69.47%, 35 were Gram-positive bacteria, accounting for 26.72% and 5 were fungi, accounting for 3.81%. Drug susceptibility analysis showed that Gram-negative bacilli were more sensitive to levofloxacin, piperacillin / tazobactam and imipenem. Gram-positive cocci were more sensitive to levofloxacin, azithromycin and vancomycin. Conclusions The distribution of pathogens in neonatal pneumonia is mainly Gram-negative bacteria. The detection of pathogenic bacteria and the analysis of bacterial resistance are of great importance for rational use of clinical antibiotics in neonates and alleviating the occurrence of drug-resistant strains.