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目的探讨新生儿感染性肺炎革兰阳性菌分布及耐药性,为临床预防及诊治提供参考依据。方法对310例临床诊断为新生儿感染性肺炎患儿痰液进行细菌培养和耐药性检测。结果310例肺炎患儿中,共检出病原菌151株,阳性率为48.7%,革兰阳性菌49株,占32.5%,主要为金黄色葡萄球菌和表皮葡萄球菌,共39株。革兰阳性菌对青霉素、氯林可霉素、红霉素耐药率高,仅对万古霉素敏感。葡萄球菌中耐甲氧西林葡萄球菌(MRS)22株,总分离率为56.4%,耐甲氧西林金黄色葡萄球菌(MRSA)10株占40.0%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)12株占85.7%。结论革兰阳性菌是新生儿肺炎的主要病原菌,开展细菌耐药性的监测对新生儿科抗菌药物的合理应用,提高疗效,减缓耐药菌株的发生与发展有重要意义。
Objective To investigate the distribution and drug resistance of Gram-positive bacteria in neonatal infectious pneumonia and to provide a reference for clinical prevention and treatment. Methods Bacterial culture and drug resistance of sputum from 310 children with neonatal pneumonia were detected. Results A total of 151 pathogenic bacteria were detected in 310 children with pneumonia. The positive rate was 48.7%. Gram-positive bacteria were 49 (32.5%), mainly Staphylococcus aureus and Staphylococcus epidermidis, with 39 strains. Gram-positive bacteria penicillin, clindamycin, erythromycin high rate of resistance, only sensitive to vancomycin. Staphylococcus aureus methicillin-resistant Staphylococcus aureus (MRS) 22 strains, the total separation rate of 56.4%, methicillin-resistant Staphylococcus aureus (MRSA) 10 40.0%, methicillin-resistant coagulase-negative Staphylococcus aureus (MRCNS ) 12 strains accounted for 85.7%. Conclusions Gram-positive bacteria is the main pathogen of neonatal pneumonia. To carry out the monitoring of bacterial drug resistance is of great significance to rational use of neonatal antimicrobial agents, to improve the curative effect and to reduce the occurrence and development of resistant strains.