江西医药
江西醫藥
강서의약
JIANGXI MEDICAL JOURNAL
2014年
6期
478-481
,共4页
新生儿%重症监护室%多重耐药%感染
新生兒%重癥鑑護室%多重耐藥%感染
신생인%중증감호실%다중내약%감염
Neonatal%Intensive care unit%Multiple resistance%Infections
目的：了解我院新生儿重症监护室（NICU）多重耐药菌的菌种和耐药情况。方法对本院NICU2011年4月-2012年3月发生多重耐药菌感染的44例新生儿细菌监测结果进行分析。结果共检出多重耐药菌48株，革兰阴性菌38株，占79.17%，以鲍曼/溶血不动杆菌最多（17株），产超广谱β内酰胺酶（ESBL）阳性14株，占29.17%；鲍曼/溶血不动杆菌对亚胺培南耐药率为76.47%，仅对阿米卡星、妥布霉素敏感，其它革兰阴性菌对氨苄青霉素、氨曲南、除头孢西丁外的头孢类抗生素、哌拉西林耐药率高。革兰阳性菌10株，占20.83%，对阿莫西林/克拉维酸、头孢唑啉、亚胺培南、氨苄青霉素、苯唑青霉素、青霉素耐药率为100%，对利奈唑烷、利福平、万古霉素、奎奴普丁/达福普丁敏感。48株多重耐药菌对3-10类抗生素耐药，平均对6.44+1.66类抗生素耐药。治愈34例，好转3例，死亡2例，自动出院后死亡5例，病死率为15.91%（7/44）。结论本院NICU多重耐药菌感染病原菌以革兰阴性菌为主，对大部分抗生素耐药。
目的：瞭解我院新生兒重癥鑑護室（NICU）多重耐藥菌的菌種和耐藥情況。方法對本院NICU2011年4月-2012年3月髮生多重耐藥菌感染的44例新生兒細菌鑑測結果進行分析。結果共檢齣多重耐藥菌48株，革蘭陰性菌38株，佔79.17%，以鮑曼/溶血不動桿菌最多（17株），產超廣譜β內酰胺酶（ESBL）暘性14株，佔29.17%；鮑曼/溶血不動桿菌對亞胺培南耐藥率為76.47%，僅對阿米卡星、妥佈黴素敏感，其它革蘭陰性菌對氨芐青黴素、氨麯南、除頭孢西丁外的頭孢類抗生素、哌拉西林耐藥率高。革蘭暘性菌10株，佔20.83%，對阿莫西林/剋拉維痠、頭孢唑啉、亞胺培南、氨芐青黴素、苯唑青黴素、青黴素耐藥率為100%，對利奈唑烷、利福平、萬古黴素、奎奴普丁/達福普丁敏感。48株多重耐藥菌對3-10類抗生素耐藥，平均對6.44+1.66類抗生素耐藥。治愈34例，好轉3例，死亡2例，自動齣院後死亡5例，病死率為15.91%（7/44）。結論本院NICU多重耐藥菌感染病原菌以革蘭陰性菌為主，對大部分抗生素耐藥。
목적：료해아원신생인중증감호실（NICU）다중내약균적균충화내약정황。방법대본원NICU2011년4월-2012년3월발생다중내약균감염적44례신생인세균감측결과진행분석。결과공검출다중내약균48주，혁란음성균38주，점79.17%，이포만/용혈불동간균최다（17주），산초엄보β내선알매（ESBL）양성14주，점29.17%；포만/용혈불동간균대아알배남내약솔위76.47%，부대아미잡성、타포매소민감，기타혁란음성균대안변청매소、안곡남、제두포서정외적두포류항생소、고랍서림내약솔고。혁란양성균10주，점20.83%，대아막서림/극랍유산、두포서람、아알배남、안변청매소、분서청매소、청매소내약솔위100%，대리내서완、리복평、만고매소、규노보정/체복보정민감。48주다중내약균대3-10류항생소내약，평균대6.44+1.66류항생소내약。치유34례，호전3례，사망2례，자동출원후사망5례，병사솔위15.91%（7/44）。결론본원NICU다중내약균감염병원균이혁란음성균위주，대대부분항생소내약。
Objective To investigate the strain and multiple resistance to antibiotics of pathogenic bacteria of nosocomial in-fection in Neonatal Intensive Care Unit (NICU). Methods Bacterial detection were carried out with the total of 44 specimens,col-lected from NICU between April 2011 and March 2012. Results In 44 specimens,a total of 48 strains were isolated,among which 38 were gram-negative bacteria with 79.17%,the majority were acinetobacter baumannii with 17 strains,14 strains were extended-spectrum-β-lactamase (ESBL) with 29.17%. The drug resistance rates of acinetobacter baumannii to imipenem were 76.47%,it was only sensitive to amikacin and nebcin. The drug resistance rates of the other gram-negative bacteria to ampicillin,aztreonam, the cephalosporin antibiotics besides cefoxitin and piperacillin were high. A total of 10 strains were gram-positive bacilli with 20. 83%. All of the drug resistance rates were 100% to amoxicillin clavulanic acid,cefazolin,ampicillin,oxacillin and penicillin,they were sensitive to linezolid,rifampicin,vancomycin and quinupristin/dafoe putin. 48 strains of multiple resistance to antibiotics of pathogenic bacteria were resistant to 3-10 kinds of antibiotics,the average were 6.44+1.66 kinds. 34 specimens were cured,3 were improved,2 were died,5 were died after leaved hospital automatic,the case fatality rate was 15.91%(7/44). Conclusion Gram-negative bacilli are the major pathogens that cause neonatal nosocomial infections in NICU of our hospital.
