CAJ | 학술논문

目的：探讨新生儿木糖氧化无色杆菌败血症的临床特征及耐药性。方法回顾性分析2012年3月至2013年12月间，发生木糖氧化无色杆菌败血症新生儿的临床资料。结果研究期间共13例患儿发生18次木糖氧化无色杆菌败血症，3例(23.1%)为暴发性感染。所有患儿均早产，8例(61.5%)出生体质量<1000 g。早产、全肠外营养、接受广谱抗菌药物治疗和脐静脉导管留置是诱发原因。早产合并呼吸窘迫综合征是最主要的诊断。常见的临床特征为血小板减少、腹胀、中性粒细胞减少和呼吸暂停。所有临床分离株对复方新诺明和美罗培南敏感，对其他抗菌药物的敏感性存在差异。结论木糖氧化无色杆菌具有潜在的引起严重院内新生儿感染的风险，准确及时的药敏分析，同时兼顾不同新生儿的基础病情，可使新生儿败血症得到良好控制。
목적：탐토신생인목당양화무색간균패혈증적림상특정급내약성。방법회고성분석2012년3월지2013년12월간，발생목당양화무색간균패혈증신생인적림상자료。결과연구기간공13례환인발생18차목당양화무색간균패혈증，3례(23.1%)위폭발성감염。소유환인균조산，8례(61.5%)출생체질량<1000 g。조산、전장외영양、접수엄보항균약물치료화제정맥도관류치시유발원인。조산합병호흡군박종합정시최주요적진단。상견적림상특정위혈소판감소、복창、중성립세포감소화호흡잠정。소유림상분리주대복방신낙명화미라배남민감，대기타항균약물적민감성존재차이。결론목당양화무색간균구유잠재적인기엄중원내신생인감염적풍험，준학급시적약민분석，동시겸고불동신생인적기출병정，가사신생인패혈증득도량호공제。
Objective To investigate outbreak of Achromobacter xylosoxidans in neonatesand present clinical and laboratory data of the patients. Methods All the neonates with bacteremia due to Achromobacter xylosoxidansfrom Mar 2012 to Dec 2013 were retrospectively analyzed. Results Eighteen episodes of bacteremia occurred in 13 neonates. All neonates were preterm newborns and 61.5%(8/13) had birth weight<1000 g. Prematurity, total parenteral nutrition, previous broad spectrum antibiotic therapy and umbilical venous catheter use were predisposing factors. Prematurity and respiratory distress syndrome were the most common diagnosis at admission. The frequent features were thrombocytopenia, abdominal distention, neutropenia and apnea. Three (23.1%) episodes were breakthrough infections. All isolates were susceptible to Trimethoprim-sulfametoxazole and Meropenem, but showed varied susceptibility to other antibiotics. Conclusions Achromobacter xylosoxidans has potential risk of serious infections in neonate, inviting close attention to early diagnosis. Timely and accurate susceptibility testing and conside-ration for predisposing factors could help to control neonatal bacteremia.