CAJ | 학술논문

目的分析本院新生儿败血症社区感染和院内感染的病原菌分布及药物敏感情况，以指导临床抗生素应用。方法对2009年6月至2011年9月本院新生儿科收治的新生儿败血症114例，分为社区感染组和院内感染组，并对新生儿败血症患儿病原菌、药敏结果进行分析。结果社区获得性感染败血症主要病原菌为革兰氏阳性凝固酶阴性葡萄球菌(CNS)，对青霉素、苯唑西林、红霉素有很高的耐药率，多重耐药亦较高，对万古霉素感性好，对喹喏酮类敏感性较高。医院感染主要病原菌为革兰氏阴性杆菌产ESBLs肺炎克雷伯菌，对青霉素类、氨曲南、头孢类耐药高，对亚胺培南、万古霉素敏感，对喹喏酮类敏感性较高。结论凝固酶阴性葡萄球菌和ESBLs肺炎克雷伯菌分别是新生儿社区获得性感染败血症与医院感染败血症的主要病原菌。两种病原菌对多数常用抗生素普遍耐药，临床医师应根据病原菌及药敏结果合理使用抗生素，对提高新生儿抗感染治疗具有重要意义。
목적분석본원신생인패혈증사구감염화원내감염적병원균분포급약물민감정황，이지도림상항생소응용。방법대2009년6월지2011년9월본원신생인과수치적신생인패혈증114례，분위사구감염조화원내감염조，병대신생인패혈증환인병원균、약민결과진행분석。결과사구획득성감염패혈증주요병원균위혁란씨양성응고매음성포도구균(CNS)，대청매소、분서서림、홍매소유흔고적내약솔，다중내약역교고，대만고매소감성호，대규야동류민감성교고。의원감염주요병원균위혁란씨음성간균산ESBLs폐염극뢰백균，대청매소류、안곡남、두포류내약고，대아알배남、만고매소민감，대규야동류민감성교고。결론응고매음성포도구균화ESBLs폐염극뢰백균분별시신생인사구획득성감염패혈증여의원감염패혈증적주요병원균。량충병원균대다수상용항생소보편내약，림상의사응근거병원균급약민결과합리사용항생소，대제고신생인항감염치료구유중요의의。
Objective To investigate the pathogens responsible for community-acquired and hospital–acquired neonatal septicemia and the antibiotic susceptibility characteristics of the pathogenic bacteria in order to provide guidance on clinicalmedication. Methods A retrospective analysis was conducted on 92 cases of neonatal septicemia that were admitted to the neonatal section of our hospital"Division of Neonatology during June,2009 to Sep,2011. The cases were divided into community-acquired infection groups and hospital-acquired infection groups according to the onset, and their blood culture pathogenic bacteria and drug susceptibility results were analyzed. Results The bacteria in the community - acquired infection were mainly coagulase-negative staphylococcus (CNS), Staphylococcus was resistant to penicillin.oxacillin.erythromycin. highly susceptible to vancomycin-susceptibility ,but were still sensitive to quinolones.The bacteria in the hospital-acquired infection were mainly Klebsiella pneumoniae of Extended spectrumβ-lactamases (ESBLS) producing Gram-negative bacteria, Extended spectrum β-lactamases (ESBLS) producing Gram-negative bacteria were resistant to penicillins as well as the aztreonam and cephalosporins. They were highly susceptible to Imipenem and vancomycin, susceptible to quinolones. Conclusions The coagulase-negative staphylococcus (CNS) and Klebsiella pneumoniae of Extended spectrum β-lactamases (ESBLS) producing Gram-negative bacteria was community-acquired neonatal septicemia and hospital–acquired neonatal neonatal septicemia of major pathogenic bacteria. Two kinds of pathogenic bacteria for most commonly used drug resistance in common antibiotics, Clinicians should according to bacterial indentification and susceptibility testing to select sensitive drugs for treatment, to improve the neonatal anti-infection treatment is important.