安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2015年
4期
450-453
,共4页
黄玲玲%王宁玲%梁霞%刘周
黃玲玲%王寧玲%樑霞%劉週
황령령%왕저령%량하%류주
败血症,新生儿%病原学%耐药性
敗血癥,新生兒%病原學%耐藥性
패혈증,신생인%병원학%내약성
Sepsis,neonate%Etiology%Drug resistance
目的:分析新生儿败血症病原学特点及致病菌耐药情况。方法回顾性分析81例新生儿败血症血培养及药敏试验结果。结果共检出病原菌81株,其中革兰阳性菌42株(51.85%),革兰阴性菌34株(41.98%),真菌5株(6.17%)。革兰阳性菌中检出耐甲氧西林凝固酶阴性葡萄球菌25株(59.52%),革兰阴性菌中检出产超广谱β内酰胺酶(产 ESBLs )菌12株(35.29%)。排在前5位的细菌为表皮葡萄球菌、肺炎克雷伯菌、大肠埃希菌、产气肠杆菌及阴沟肠杆菌。革兰阳性菌对青霉素100%耐药,对红霉素、复方新诺明、克林霉素耐药率高(52.00%~100.00%),对万古霉素、利奈唑胺尚无耐药。革兰阴性菌对氧哌嗪青霉素、头孢呋辛、头孢噻肟、头孢曲松、头孢他啶均有较高耐药率(42.86%~100.00%),其中产ESBLs菌对上述几种药物及头孢吡肟100%耐药,对含酶抑制剂的抗菌药物耐药率相对较低(0%~33.33%),未发现对亚胺培南、美罗培南耐药菌株。真菌中白色念珠菌最多见,未发现对氟康唑、伊曲康唑、伏立康唑及两性霉素B耐药菌株。结论根据血培养及药敏试验结果选择治疗用药更合理、有效,并可减少耐药菌株产生。
目的:分析新生兒敗血癥病原學特點及緻病菌耐藥情況。方法迴顧性分析81例新生兒敗血癥血培養及藥敏試驗結果。結果共檢齣病原菌81株,其中革蘭暘性菌42株(51.85%),革蘭陰性菌34株(41.98%),真菌5株(6.17%)。革蘭暘性菌中檢齣耐甲氧西林凝固酶陰性葡萄毬菌25株(59.52%),革蘭陰性菌中檢齣產超廣譜β內酰胺酶(產 ESBLs )菌12株(35.29%)。排在前5位的細菌為錶皮葡萄毬菌、肺炎剋雷伯菌、大腸埃希菌、產氣腸桿菌及陰溝腸桿菌。革蘭暘性菌對青黴素100%耐藥,對紅黴素、複方新諾明、剋林黴素耐藥率高(52.00%~100.00%),對萬古黴素、利奈唑胺尚無耐藥。革蘭陰性菌對氧哌嗪青黴素、頭孢呋辛、頭孢噻肟、頭孢麯鬆、頭孢他啶均有較高耐藥率(42.86%~100.00%),其中產ESBLs菌對上述幾種藥物及頭孢吡肟100%耐藥,對含酶抑製劑的抗菌藥物耐藥率相對較低(0%~33.33%),未髮現對亞胺培南、美囉培南耐藥菌株。真菌中白色唸珠菌最多見,未髮現對氟康唑、伊麯康唑、伏立康唑及兩性黴素B耐藥菌株。結論根據血培養及藥敏試驗結果選擇治療用藥更閤理、有效,併可減少耐藥菌株產生。
목적:분석신생인패혈증병원학특점급치병균내약정황。방법회고성분석81례신생인패혈증혈배양급약민시험결과。결과공검출병원균81주,기중혁란양성균42주(51.85%),혁란음성균34주(41.98%),진균5주(6.17%)。혁란양성균중검출내갑양서림응고매음성포도구균25주(59.52%),혁란음성균중검출산초엄보β내선알매(산 ESBLs )균12주(35.29%)。배재전5위적세균위표피포도구균、폐염극뢰백균、대장애희균、산기장간균급음구장간균。혁란양성균대청매소100%내약,대홍매소、복방신낙명、극림매소내약솔고(52.00%~100.00%),대만고매소、리내서알상무내약。혁란음성균대양고진청매소、두포부신、두포새우、두포곡송、두포타정균유교고내약솔(42.86%~100.00%),기중산ESBLs균대상술궤충약물급두포필우100%내약,대함매억제제적항균약물내약솔상대교저(0%~33.33%),미발현대아알배남、미라배남내약균주。진균중백색념주균최다견,미발현대불강서、이곡강서、복립강서급량성매소B내약균주。결론근거혈배양급약민시험결과선택치료용약경합리、유효,병가감소내약균주산생。
Objective To investigate the distribution and antibiotic resistance of isolated pathogens in neonatal sepsis. Methods The results of blood culture and drug susceptibility test in neonates sepsis from January 2012 to September 2014 were retrospectively analyzed. Results Eighty one strains were detected in the blood samples,with 42 (51. 85%)Gram-positive bacteria,34 (41. 98%)Gram-negative bacteria and 5(6. 17%)fungus. Staphylococcus epidermidis,Klebsiella pneumonia,Escherichia coli,Enterobacter aerogenes,and Enter-obacter cloacae were the five most common pathogens. Gram-positive cocci was strongly resistant to pencillin(100. 00%),erythromyci,cotri-moxazole,clindamycin(52. 00% ~100. 00%),but still sensitive to vancomycin and linezolid. Gram-negative bacteria was strongly resistant to piperacillin,cefuroxime,cefotaxime,Ceftriaxone,and ceftazidime(42. 86% ~100. 00%). The resistance rate of extended-spectrum beta-lactamase producing bacteria to piperacillin,cefuroxime,cefotaxime,Ceftriaxone,ceftazidime and cefepime was 100. 00%,but low tocompound containing beta-lactamase inhibitors (such as Amoxicillin/acid, Piperacillin/Tazobactam and ticarcillin/acid ) (0. 00% ~33. 33%). The resistance rate of bacteria to imipenem and meropenem was 0. 00%. Conclusion The selection of sensitive antibiotics based on pathogens and drug resistance testing for the treatment of neonatal sepsis is more reasonable and more effective,which can reduce the gen-eration of drug-resistant strains.