中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
22期
30-31,36
,共3页
杨晓黎%陈涛%杨静容%吴让琼
楊曉黎%陳濤%楊靜容%吳讓瓊
양효려%진도%양정용%오양경
抗生素%新生儿感染性肺炎%耐药菌%痰培养%咽拭子%直肠拭子%革兰染色法
抗生素%新生兒感染性肺炎%耐藥菌%痰培養%嚥拭子%直腸拭子%革蘭染色法
항생소%신생인감염성폐염%내약균%담배양%인식자%직장식자%혁란염색법
Antibiotics%Infectious pneumonia of neonatal%Resistant bacteria%Sputum culture%Throat swab%Rectal swab%Gram’s staining
目的通过对病原学的快速检测，及时了解本院新生儿感染性肺炎的病原菌及耐药菌构成，指导临床合理使用抗生素。方法对368例住院患儿行痰涂片、咽拭子筛查、直肠拭子筛查，并与同期进行的痰培养结果比较。结果368例痰涂片标本中阳性标本201例，阳性率为54.6%。其中革兰阳性菌75株，占37.3%；革兰阴性菌126株，占62.7%。368例痰培养标本中阳性标本183例，阳性率为49.7%。其中革兰阳性菌67株，占18.2%；革兰阴性菌116株，占31.5%。368例咽拭子标本中耐甲氧西林金黄色葡萄球菌阳性标本11株，阳性率为3.0%；产超广谱β-内酰胺酶菌阳性标本3株，阳性率0.8%。368例直肠拭子标本中超广谱β-内酰胺酶菌阳性标本28株，阳性率为7.6%；未查见耐甲氧西林金黄色葡萄球菌阳性标本。结论痰涂片的快速初筛与痰培养病原菌分类一致性较高，咽拭子及直肠拭子对耐药菌的筛查与痰培养结果有高度一致性，可以根据痰涂片、咽拭子及直肠拭子筛查结果快速、有依据地选用抗生素治疗新生儿感染性肺炎。
目的通過對病原學的快速檢測，及時瞭解本院新生兒感染性肺炎的病原菌及耐藥菌構成，指導臨床閤理使用抗生素。方法對368例住院患兒行痰塗片、嚥拭子篩查、直腸拭子篩查，併與同期進行的痰培養結果比較。結果368例痰塗片標本中暘性標本201例，暘性率為54.6%。其中革蘭暘性菌75株，佔37.3%；革蘭陰性菌126株，佔62.7%。368例痰培養標本中暘性標本183例，暘性率為49.7%。其中革蘭暘性菌67株，佔18.2%；革蘭陰性菌116株，佔31.5%。368例嚥拭子標本中耐甲氧西林金黃色葡萄毬菌暘性標本11株，暘性率為3.0%；產超廣譜β-內酰胺酶菌暘性標本3株，暘性率0.8%。368例直腸拭子標本中超廣譜β-內酰胺酶菌暘性標本28株，暘性率為7.6%；未查見耐甲氧西林金黃色葡萄毬菌暘性標本。結論痰塗片的快速初篩與痰培養病原菌分類一緻性較高，嚥拭子及直腸拭子對耐藥菌的篩查與痰培養結果有高度一緻性，可以根據痰塗片、嚥拭子及直腸拭子篩查結果快速、有依據地選用抗生素治療新生兒感染性肺炎。
목적통과대병원학적쾌속검측，급시료해본원신생인감염성폐염적병원균급내약균구성，지도림상합리사용항생소。방법대368례주원환인행담도편、인식자사사、직장식자사사，병여동기진행적담배양결과비교。결과368례담도편표본중양성표본201례，양성솔위54.6%。기중혁란양성균75주，점37.3%；혁란음성균126주，점62.7%。368례담배양표본중양성표본183례，양성솔위49.7%。기중혁란양성균67주，점18.2%；혁란음성균116주，점31.5%。368례인식자표본중내갑양서림금황색포도구균양성표본11주，양성솔위3.0%；산초엄보β-내선알매균양성표본3주，양성솔0.8%。368례직장식자표본중초엄보β-내선알매균양성표본28주，양성솔위7.6%；미사견내갑양서림금황색포도구균양성표본。결론담도편적쾌속초사여담배양병원균분류일치성교고，인식자급직장식자대내약균적사사여담배양결과유고도일치성，가이근거담도편、인식자급직장식자사사결과쾌속、유의거지선용항생소치료신생인감염성폐염。
Objective To analyze the distribution and resistance pattern of pathogen isolated from infectious pneumonia of neonatal within 2 hours of hospitalization by sputum smear、bacterial culture、throat swab and rectal swab,and to provide guidance for clinical diagnosis and treatment. Methods Sputum specimens were performed sputum smear and Gram’s staining within 2 hours of admission and bacterial culture、throat swab and rectal swab were also performed from 368 newborns with pneumonia to find any difference among these methods.Results 368 pathogens were isolated from qualified samples,the positive rate of sputurn smear was 54.6%,there were 75 strains of Gram-positive germ,126 strains of Gram-negativegerm.The positive rate was 49.7%in sputum culture.In the etiological resistant bacterial species,the positive rate of methicillin resistant Staphylococcus aureus was 3.0%in throat swab,comparison with sputum culture was 2.4%;the positive rate of extended spectrum beta-lactamase producing bacteria was 7.6%in rectal swab,comparison with sputum culture was 9.5%.Conclusion There is a high coincidence rate between the results of sputurn smear and bacterial culture;there is a high coincidence rate between the results of throat swab、rectal swab and bacterial culture on resistant bacteria;Taking sputurn smear and monitoring the throat swab and rectal swab of infectious pneumonia of neonatal newly admitted has provided a early guidance for rational application of antibiotics.
