| 摘要: |
| 目的：总结某三级医院新生儿重症监护室肺炎克雷伯菌属感染患儿的临床特征及肺炎克雷伯菌属的耐药性，为临床早期诊断和合理用药提供依据。方法：回顾性分析62例肺炎克雷伯菌属培养阳性患儿的临床资料，包括胎龄、分娩方式、年龄、出生体质量、住院时间、基础疾病、血常规、C-反应蛋白、药敏结果、转归等。结果：62例患儿中，早产儿37例（59.68%），足月儿23例（37.10%），过期产儿2例（3.23%）。24例痰培养或气管插管导管末端培养1次阳性，11例胃液培养1次阳性，12例2次以上不同部位（痰、胃液、气管插管末端、尿液及分泌物）培养阳性。其中55例有基础疾病，包括呼吸窘迫综合征19例，肺部感染13例，呼吸窘迫综合征10例，窒息及并发症8例，败血症3例，坏死性小肠结肠炎2例。平均住院时间24.3 d。62例患儿中，治愈54例（87.10%），好转5例（8.06%），放弃治疗2例（3.23%），死亡1例（1.61%）。肺炎克雷伯菌对氨苄西林100%耐药，分离出耐碳青酶烯类肺炎克雷伯杆菌。结论：新生儿科重症监护室肺炎克雷伯菌属感染的发生受多种因素的影响，临床应根据药敏结果合理使用抗菌药物，同时采取综合防治措施遏制感染。 |
| 关键词: 肺炎克雷伯菌属 新生儿 重症监护室 临床特征 耐药性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.02.016 |
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| 基金项目: |
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| Clinical Characteristics and Drug Resistance in Neonates Infected with Klebsiella Pneumonia in the Neonatal Intensive Care Unit |
| Cheng Ying, Lei Xinyun |
| (Maternal and Children ′s Health Hospital of Hubei Province, Hubei Wuhan 430070, China) |
| Abstract: |
| Objective: To study the clinical characteristics of Klebsiella pneumonia (KPN)-positive neonates in the neonatal intensive care unit, and to provide a basis for early diagnosis and reasonable treatment of KPN infection. Methods: The clinical data of 62 neonates infected with KPN in the neonatal intensive care unit were retrospectively reviewed, including gestational age, delivery mode, age, birth weight, hospital stay duration, underlying diseases, blood routine, C- reactive protein, drug sensitivity test results, prognosis et al. Results: Of the 62 KPN-positive neonates, 37 cases (59.68%) were preterm infants, and 23 cases (37.10%) term infants, with 2 cases (3.23%) postterm infants. Twenty-four cases showed one positive result for sputum culture or endotracheal tube aspirates culture, 11 cases showed one positive result for gastric juice culture, and 10 cases showed more than two positive results for sputum, gastric juice, urine or endotracheal tube aspirates cultures. Fifty-five neonates had underlying diseases, including 19 cases of respiratory distress syndrome, 13 cases of pneumonia, 10 cases of hyaline membrane disease, 8 cases of asphyxia neonatorum, 3 cases of sepsis and 2 cases necrotizing enterocolitis. The mean hospital stay duration was 24.3 days. In the 62 neonates, 54 (87.10%) were cured and 5 (8.06%) cases showed improvements, with 2 (3.23%) cases giving-up of treatment and 1 (1.61%) died. 100% of Klebsiella pneumonia isolates were resistant to ampicillin. Carbapenem-resistant Klebsiella pneumonia (CRKP) were isolated. Conclusion: There are a variety of factors related to the infection of Klebsiella pneumonia in the neonatal intensive care unit. It is necessary for the pediatrists to use antimicrobial agents rationally and for the hospital to take targeted prevention countermeasures so as to effectively control the infections. |
| Key words: Klebsiella pneumonia Neonatal Intensive care unit Clinical characteristics Drug resistance |
