中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2014年
12期
35-37
,共3页
新生儿败血症%病原菌%耐药性
新生兒敗血癥%病原菌%耐藥性
신생인패혈증%병원균%내약성
Neonatal septicemia%Pathogen%Antibiotic resistance
目的：探讨新生儿败血症的临床特点、病原菌分布及抗生素耐药状况，指导早期诊断、合理防治。方法选择该院新生儿科住院诊断为新生儿败血症的137例病例，对其临床表现、致病菌及药敏试验进行回顾性分析。结果该院诊断败血症病例中血培养阳性率为64.2%。革兰氏阳性菌占72.2%，金黄色葡萄球菌与表皮葡萄球菌分别占43.3%和15.6%，对苯唑西林的耐药率分别为48.7%、42.9%，对青霉素、红霉素耐药率较高，对美罗培南、替考拉宁、万古霉素耐药率较低。革兰氏阴性菌中大肠埃希菌占首位。早期新生儿败血症与晚期新生儿菌种比较，早期败血症革兰氏阴性菌感染率高于晚期，晚期败血症革兰氏阳性菌感染率高于早期，两者比较差异有统计学意义。结论葡萄球菌为该院新生儿败血症主要致病菌；应做好孕期感染的防治，加强围产期及新生儿期保健，以减少新生儿败血症的发生；新生儿可选抗生素少，应根据临床表现，结合药敏合理用药。
目的：探討新生兒敗血癥的臨床特點、病原菌分佈及抗生素耐藥狀況，指導早期診斷、閤理防治。方法選擇該院新生兒科住院診斷為新生兒敗血癥的137例病例，對其臨床錶現、緻病菌及藥敏試驗進行迴顧性分析。結果該院診斷敗血癥病例中血培養暘性率為64.2%。革蘭氏暘性菌佔72.2%，金黃色葡萄毬菌與錶皮葡萄毬菌分彆佔43.3%和15.6%，對苯唑西林的耐藥率分彆為48.7%、42.9%，對青黴素、紅黴素耐藥率較高，對美囉培南、替攷拉寧、萬古黴素耐藥率較低。革蘭氏陰性菌中大腸埃希菌佔首位。早期新生兒敗血癥與晚期新生兒菌種比較，早期敗血癥革蘭氏陰性菌感染率高于晚期，晚期敗血癥革蘭氏暘性菌感染率高于早期，兩者比較差異有統計學意義。結論葡萄毬菌為該院新生兒敗血癥主要緻病菌；應做好孕期感染的防治，加彊圍產期及新生兒期保健，以減少新生兒敗血癥的髮生；新生兒可選抗生素少，應根據臨床錶現，結閤藥敏閤理用藥。
목적：탐토신생인패혈증적림상특점、병원균분포급항생소내약상황，지도조기진단、합리방치。방법선택해원신생인과주원진단위신생인패혈증적137례병례，대기림상표현、치병균급약민시험진행회고성분석。결과해원진단패혈증병례중혈배양양성솔위64.2%。혁란씨양성균점72.2%，금황색포도구균여표피포도구균분별점43.3%화15.6%，대분서서림적내약솔분별위48.7%、42.9%，대청매소、홍매소내약솔교고，대미라배남、체고랍저、만고매소내약솔교저。혁란씨음성균중대장애희균점수위。조기신생인패혈증여만기신생인균충비교，조기패혈증혁란씨음성균감염솔고우만기，만기패혈증혁란씨양성균감염솔고우조기，량자비교차이유통계학의의。결론포도구균위해원신생인패혈증주요치병균；응주호잉기감염적방치，가강위산기급신생인기보건，이감소신생인패혈증적발생；신생인가선항생소소，응근거림상표현，결합약민합리용약。
Objective To investigate the clinical characteristics of neonatal septicemias admitted in our hospital, and the distribu-tion of pathogens causing neonatal septicemia and their antibiotic resistance so as to guide the early diagnosis and rational preven-tion and treatment. Methods The clinical data of 137 cases of neonates diagnosed with neonatal septicemia in Department of Neonatology of our hospital from January, 2009 to January, 2013 were selected, the clinical characteristics, pathogen and drug sen-sitivity results of the neonates were analyzed retrospectively. Results In 137 newborns with septicemia, the positive blood culture rate was 64.2%, the gram-positive bacteria accounted for 72.2%, of which, staphylococcus aureus accounted for 43.3%, and S. epidermidis accounted for 15.6%. The ratio of oxacillin-resistant staphylococcus aureus and S. epidermidis was 48.7%and 42.9%, respectively, and which had high resistant rates to penicillin and erythromycin, but had low resistant rates to meropenem, te-icoplanin, vancomycin. Escherichia coli was in the first place among gram-negative bacteria. In the comparison of early neonatal septicemia and late neonatal species, the former had a higher gram-negative bacteria infection rate than the latter, and the latter had a higher gram-positive bacteria infection rate than the former, the difference between the two was statistically significant. Conclusion Staphylococcus is the main pathogen of neonatal septicemias in our hospital. Infection should be prevented and treated during pregnancy, and the health care in perinatal and neonatal period should be strengthened so as to reduce the occurrence of neonatal septicemia. Antibiotics for neonates are limited, so rational administration should be based on the clinical manifestations and antimicrobial susceptibility tests.
