发育医学电子杂志  2020, Vol. 8 Issue (3): 239-245 DOI: 10.3969/j.issn.2095-5340.2020.03.009 |
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围产医学
论著
｜新生儿
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新生儿败血症病原菌分布及药敏分析
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姚恩凤 陈中举 陈玲
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华中科技大学同济医学院附属同济医院 儿科，湖北 武汉 430030
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Pathogen distribution and antibiotic resisitance analysis of neonatal sepsis
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Yao Enfeng, Chen Zhongju, Chen Ling
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Department of Pediatric, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Hubei Wuhan 430030, China
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摘要
【摘要】 目的 探讨近 7 年本院新生儿败血症患儿的病原菌分布及药敏特点。 方法 选取 2012 年 1 月
至 2018 年 12 月华中科技大学同济医学院附属同济医院新生儿科血培养阳性的败血症患儿 239 例，对 其病原菌构成及药敏试验结果进行回顾性分析。 结果 近 7 年本院 NICU 新生儿败血症的发生率 为 2.03%（239/11 780）。239 例新生儿败血症患儿血培养标本中共检出病原菌 250 株，其中革兰氏阳 性菌 103 株（41.2%），革兰氏阴性菌 139 株（55.6%），真菌 8 株（3.2%）。凝固酶阴性葡萄球菌（coagulase negative staphylococcus，CNS）、无乳链球菌、肠球菌属、肺炎克雷伯菌、大肠埃希菌的每年检出数占血培
养阳性菌株的构成比差异有统计学意义（P<0.05）。革兰氏阳性菌中主要以 CNS、无乳链球菌、肠球菌
属以及金黄色葡萄球菌为主，分别占全部病原菌的 17.6%、8.4%、8.4%、5.6%。CNS 对常用抗生素青霉
素、头孢西丁、红霉素表现出高度耐药性（79.5% ～ 97.7%），尚未检测出对利奈唑胺、替考拉宁和万古霉
素耐药的菌株。常见的革兰氏阴性杆菌（肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌）对氨苄西林耐药率
极高（84.8% ～ 100.0%），对替加环素绝对敏感。肺炎克雷伯菌对常用头孢菌素如头孢唑啉、头孢呋辛、
头孢噻肟耐药率达 90.0% 以上，对碳青霉烯类抗生素（亚胺培南、美罗培南）有较高的耐药率（46.7% 和
45.3%）。 结论 本院新生儿败血症病原菌以革兰氏阴性杆菌为主，且对常见抗生素耐药率高。需及时
监测病原菌种类分布及耐药变迁，以便于指导临床规范、合理地使用抗菌药物。
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| 关键词:
新生儿败血症')" href="#">
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| Abstract:
【Abstract】 Objective To investigate the distribution and antibiotic resistance of pathogens in neonatal
sepsis in recent 7 years. Methods The distribution of pathogens and their drug resistance of newborns with
neonatal sepsis were retrospectively analyzed in Tongji Hospital, Tongji Medical College Huazhong University
of Science and Technology from January 2012 to December 2018. Results In the past 7 years, the incidence
of neonatal sepsis in neonatal intensive care unit was 2.03% (239/11 780). Among 239 cases of culture
proven neonatal sepsis, 250 pathogenic bacteria strains were found in blood culture including 103 gram
positive bacteria (41.2%), 139 gram-negative bacteria (55.6%), and 8 fungal (3.2%). The annual detection
rates of coagulase-negative staphylococcus (CNS) , streptococcus agalactiae, enterococcus, klebsiella
pneumoniae, escherichia coli were signifificantly different (P<0.05). Of gram-positive bacteria, the detection
rate of CNS (17.6%), streptococcus agalactiae (8.4%), enterococcus (8.4%) and staphylococcus aureus
(5.6%) were primary. CNS were highly resistant to penicillin, cefoxitin and eryphilin (79.5%-97.7%), but
no strains resistant to Linezolid, teicoplanin, and vancomycin had been found. The most common gram
negative bacteria (klebsiella pneumoniae, escherichia coli and enterobacter cloacae) were highly resistant
to penicillin (84.8%-100.0%), but sentitive to tigecycline. Klebsiella pneumoniae showed high resistance
against commonly used cephalosporins such as cefazolin, cefuroxime and cefotaxime (over 90.0%), and
there was still a high rate of resistance to carbapenems (imipenem and meropenem) (46.7% and 45.3%).
Conclusions Neonatal sepsis mainly centers on gram-negative bacteria in our hospital, and its drug
resistance rate is relatively high. The distribution of pathogenic bacteria and drug resistance should be
monitored timely in order to select an optimal antimicrobial therapy
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| Key words:
Neonatal sepsis ')" href="#">
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收稿日期: 2019-03-18
出版日期: 2020-07-30
发布日期: 2020-07-28
期的出版日期: 2020-07-30
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通讯作者:
陈玲
E-mail: chenling@tjh.tjmu.edu.cn
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