中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
23期
144-146,149
,共4页
新生儿肺炎%细菌%抗生素%微生物敏感性试验%耐药性
新生兒肺炎%細菌%抗生素%微生物敏感性試驗%耐藥性
신생인폐염%세균%항생소%미생물민감성시험%내약성
Neonatal pneumonia%Bacteria%Antibiotics%Microbial sensitivity test%Drug resistance
目的：研究新生儿肺炎的病原菌类型及其耐药特点，为临床预防和诊治提供依据。方法回顾性分析2014年1~12月759例新生儿肺炎下呼吸道分泌物细菌培养和药敏试验结果，细菌鉴定使用美国BD公司的Phoenix100细菌鉴定系统，药敏试验采用K-B纸片扩散法，结果判定以美国实验室质量标准(CLSI)2013为依据，使用WHONET5.6软件对收集的数据进行统计分析。结果759例患儿送检痰培养标本共分离病原菌245株，阳性率为32.28%，其中革兰氏阴性菌209株、革兰氏阳性菌30株、真菌6株，分别占阳性样本的85.31%、12.24%、2.45%，革兰氏阴性菌中产超广谱β-内酰胺酶菌(ESBLs)所占比为36.84%。革兰氏阴性菌对氨苄西林的耐药率较高，耐药率为94.39%~100.00%，部分头孢菌素耐药，对阿米卡星较为敏感，对碳青霉烯类抗生素无耐药性。革兰氏阳性菌对红霉素、克林霉素耐药率较高，对万古霉素有高度敏感性。结论新生儿感染性肺炎病原菌主要为革兰氏阴性菌，对阿米卡星及碳青霉烯类抗生素相对敏感，在临床治疗新生儿肺炎时应根据药敏试验结果合理使用抗生素。
目的：研究新生兒肺炎的病原菌類型及其耐藥特點，為臨床預防和診治提供依據。方法迴顧性分析2014年1~12月759例新生兒肺炎下呼吸道分泌物細菌培養和藥敏試驗結果，細菌鑒定使用美國BD公司的Phoenix100細菌鑒定繫統，藥敏試驗採用K-B紙片擴散法，結果判定以美國實驗室質量標準(CLSI)2013為依據，使用WHONET5.6軟件對收集的數據進行統計分析。結果759例患兒送檢痰培養標本共分離病原菌245株，暘性率為32.28%，其中革蘭氏陰性菌209株、革蘭氏暘性菌30株、真菌6株，分彆佔暘性樣本的85.31%、12.24%、2.45%，革蘭氏陰性菌中產超廣譜β-內酰胺酶菌(ESBLs)所佔比為36.84%。革蘭氏陰性菌對氨芐西林的耐藥率較高，耐藥率為94.39%~100.00%，部分頭孢菌素耐藥，對阿米卡星較為敏感，對碳青黴烯類抗生素無耐藥性。革蘭氏暘性菌對紅黴素、剋林黴素耐藥率較高，對萬古黴素有高度敏感性。結論新生兒感染性肺炎病原菌主要為革蘭氏陰性菌，對阿米卡星及碳青黴烯類抗生素相對敏感，在臨床治療新生兒肺炎時應根據藥敏試驗結果閤理使用抗生素。
목적：연구신생인폐염적병원균류형급기내약특점，위림상예방화진치제공의거。방법회고성분석2014년1~12월759례신생인폐염하호흡도분비물세균배양화약민시험결과，세균감정사용미국BD공사적Phoenix100세균감정계통，약민시험채용K-B지편확산법，결과판정이미국실험실질량표준(CLSI)2013위의거，사용WHONET5.6연건대수집적수거진행통계분석。결과759례환인송검담배양표본공분리병원균245주，양성솔위32.28%，기중혁란씨음성균209주、혁란씨양성균30주、진균6주，분별점양성양본적85.31%、12.24%、2.45%，혁란씨음성균중산초엄보β-내선알매균(ESBLs)소점비위36.84%。혁란씨음성균대안변서림적내약솔교고，내약솔위94.39%~100.00%，부분두포균소내약，대아미잡성교위민감，대탄청매희류항생소무내약성。혁란씨양성균대홍매소、극림매소내약솔교고，대만고매소유고도민감성。결론신생인감염성폐염병원균주요위혁란씨음성균，대아미잡성급탄청매희류항생소상대민감，재림상치료신생인폐염시응근거약민시험결과합리사용항생소。
Objective To evaluate the pathogen type and drug resistance characteristics of pathogen in neonatal pneu-monia to provide basis for clinical prevention and diagnosis and treatment. Methods Bacterial culture and drug sensi-tivity test results of lower respiratory tract secretion in 759 eases with neonatal pneumonia from January to December 2012 were analyzed retrospectively.Phoenix100 system of bacterial identification in BD company of America was used for bacterial identification,Result determination took American laboratory quality standard (CLSI) 2013 as a basis,and WHONET5.6 software was used to count statistically the collected data. Results 245 strains of pathogenic bacteria were isolated from the sputum culture specimen inspected from 759 illed children,the positive rate was 32.28%,among them, 209 strains were Gram negative bacteria,30 strains were Gram positive bacteria,6 strains were fungi,and and it account-ed for 85.31%,12.24%,2.45% of positive sample respectively.The ratio of producing extended-spectrum β- lactamase (ESBLs) bacteria in Gram-negative bacteria was 36.84%.Gram-negative bacteria had higher drug resistantance rate to ampicillin,and drug resistantance rate was 94.39%-100.00%,partial cephalosporin was drug-fast,and it was more sensi-tive to amikacin,and there was no drug resistance to carbapenem antibiotics.Gram-positive bacteria has higher drug resis-tantance rate to erythromycin,clindamycin,and it had high sensitivity to vancomycin. Conclusion Neonatal infection pneu-monia pathogens are mainly Gram negative bacteria,and relatively sensitive to amikacin and carbapenem antibiotics.In the treatment of neonatal pneumonia in clinic,antibiotics should be rationally used according to the results of drug sensitivity test.
