CAJ | 학술논문

目的：分析某院新生儿感染性肺炎分离的病原体分布及耐药情况。方法对2010年1月-2013年12月该院新生儿科及儿科重症监护室送检的新生儿痰液和气管插管末端采样标本进行培养，对分离菌株进行鉴定和药敏试验。结果共检出病原体3278株，其中革兰阳性菌1391株（42．43％），革兰阴性菌1884株（57．47％），真菌3株（0．09％）。病原体中居前5位的是金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、表皮葡萄球菌和溶血葡萄球菌，分别占22．82％、20．01％、17．33％、6．96％和4．94％。肺炎克雷伯菌和大肠埃希菌的超广谱β-内酰胺酶检出率分别为66．46％、66．55％。药敏结果显示，肺炎克雷伯菌和大肠埃希菌对哌拉西林/他唑巴坦、头孢吡肟和头孢替坦较敏感（敏感率＞84％），金黄色葡萄球菌和表皮葡萄球菌对氨苄西林/舒巴坦、磷霉素和利奈唑胺敏感率达100％。结论对新生儿感染性肺炎进行病原体监测，有助于了解新生儿感染病原体的流行趋势及耐药特点，以便合理用药，治疗新生儿感染性肺炎。
목적：분석모원신생인감염성폐염분리적병원체분포급내약정황。방법대2010년1월-2013년12월해원신생인과급인과중증감호실송검적신생인담액화기관삽관말단채양표본진행배양，대분리균주진행감정화약민시험。결과공검출병원체3278주，기중혁란양성균1391주（42．43％），혁란음성균1884주（57．47％），진균3주（0．09％）。병원체중거전5위적시금황색포도구균、폐염극뢰백균、대장애희균、표피포도구균화용혈포도구균，분별점22．82％、20．01％、17．33％、6．96％화4．94％。폐염극뢰백균화대장애희균적초엄보β-내선알매검출솔분별위66．46％、66．55％。약민결과현시，폐염극뢰백균화대장애희균대고랍서림/타서파탄、두포필우화두포체탄교민감（민감솔＞84％），금황색포도구균화표피포도구균대안변서림/서파탄、린매소화리내서알민감솔체100％。결론대신생인감염성폐염진행병원체감측，유조우료해신생인감염병원체적류행추세급내약특점，이편합리용약，치료신생인감염성폐염。
Objective To evaluate distribution and antimicrobial resistance of pathogens in neonatal infectious pneumonia.Methods Sputum specimens and ends of tracheal intubation of neonates at neonatal intensive care unit and pediatric intensive care unit between January 2010 and December 2013 were cultured,and isolated pathogens were identified and performed antimicrobial susceptibility testing.Results A total of 3 278 pathogenic isolates were isolated,1 391(42.43%)were gram-positive cocci,1 884(57.47%)were gram-negative bacilli,and 3(0.09%)were fungi.The top five pathogens were Staphylococcus aureus (22.82%),Klebsiella pneumoniae (20.01 %),Escherichia coli(17.33%),Staphylococcus epidermidis (6.96%),and Staphylococcus haemolyticus (4.94%).The detection rate of extended-spectrum β-lactamase-producing Klebsiella pneumoniae and Escherichia coli was 66.46% and 66.55%,respectively.Susceptibility rate of Klebsiella pneumoniae and Escherichia coli to piperacillin/tazobactam, cefepime and cefotetan were>84,susceptibility rates of Staphylococcus aureus and Staphylococcus epidermidis to ampicillin/sulbactam,fosfomycin and linezolid were all 100%.Conclusion Monitoring on pathogens in neonatal infectious pneumonia is helpful for realizing the epidemiological trend and drug resistance characteristics,and can promote the rational use of antimicrobial agents for the treatment of neonatal infectious pneumonia.