| 摘要: |
| [摘要]目的：了解我院新生儿重症监护室（NICU）多重耐药菌的菌种和耐药情况。方法：对本院NICU 2016年发生多重耐药菌（MDRO）感染的206例新生儿细菌监测结果进行分析。结果：共检出多重耐药菌234株，革兰阴性菌186株，占79.48%，以耐碳青霉烯类肺炎克雷伯菌（66株）最多，多重耐药鲍曼不动杆菌（49株），产超广谱β内酰胺酶（ESBL）阳性菌共59株，占31.72%；耐碳青霉烯类肺炎克雷伯菌对亚胺培南、美罗培南耐药率为96.96%，仅对阿米卡星、庆大霉素、复方磺胺甲恶唑、氯霉素、四环素部分敏感；多重耐药鲍曼不动杆菌亚胺培南、美罗培南、氨曲南、氨苄西林、哌拉西林、哌拉西林/他唑巴坦耐药率为100%，仅对阿米卡星、复方磺胺甲恶唑、四环素部分敏感；其他革兰阴性菌对头孢唑林、头孢噻肟、氨苄西林、哌拉西林耐药率高。革兰阳性菌48 株，占20.51%，对青霉素、氨苄西林、苯唑西林、阿莫西林/克拉维酸耐药率为100%，对阿米卡星、利奈唑烷、替考拉宁、万古霉素、奎奴普丁/达福普丁、呋喃妥因敏感。234株多重耐药菌对3~10类抗生素耐药，平均对（7.9±1.9）种抗菌素耐药。治愈162例，好转25例，死亡1例，自动出院18例。结论：本院NICU多重耐药菌感染病原菌以革兰阴性菌为主，对大部分抗生素耐药。 |
| 关键词: 新生儿 重症监护室 多重耐药 感染 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.06.016 |
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| 基金项目: |
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| Unit Analysis of Multiple Drug-Resistant Bacterial Infection in 206 Children in Neonatal Intensive Care Unit |
| Li Zhaohui, Kang Wenqing, Zhang Yaodong, Wang Qin, Xu Bangli, Liu Dapeng, Jin Juan, Wang Caijun, Zhou Yanjuan, Zhang Yawei, Li Rui, Wang Yingyuan, Xiong Hong |
| (Children's Hospital Affiliated to Zhengzhou University,Henan 450018, China) |
| Abstract: |
| [Abstract] Objective: To investigate the types and drug resistance of multiple drug-resistant bacteria in neonatal intensive care unit (NICU) in our hospital. Methods: Two hundreds and six cases of neonatal bacterial surveillance on multiple drug-resistant bacterial infections from Jan. 2009 to Dec. 2010 in our hospital were analyzed. Results: A total of 234 strains of multiple drug-resistant bacteria were detected and 186 were gram-negative bacteria (79.48%). The mostly was carbapenem-resistant Klebsiella pneumoniae (66 strains) and multiresistant Acinetobacter baumannii (49 strains); 59 strains of extended-spectrum β-lactamase (ESBL) positive bacteria, accounting for 31.72%; the drug resistance rate of carbapenem-resistance Klebsiella pneumoniae on imipenem and meropenem was 96.96%, which was only partially sensitive to amikacin, gentamicin, cotrimoxazole, chloramphenicol and tetracycline; the drug resistance rate of multiresistant Acinetobacter baumannii on imipenem, meropenem, aztreonam, ampicillin, piperacillin, piperacillin/tazobactam was 100%, which was only partially sensitive to amikacin, cotrimoxazole and tetracycline; other gram-negative bacteria were in high drug-resistance against cefazolin, cefotaxime, ampicillin, and piperacillin. There were 48 strains of gram-positive bacteria, accounted for 20.51%, with 100% of drug resistant to penicillin, ampicillin, oxacillin, amoxicillin/clavulanic acid, and which was sensitive to amikacin, linezolid, teicoplanin, vancomycin, quinuprine/dafupine, nitrofurantoin. Two hundreds and thirty-four strains of multiple drug-resistant bacteria were resistant to 3 to 10 categories of antibiotics, with averagely resistant to (7.9±1.92) kinds of antibiotics. Of the 206 cases of neonatal bacterial surveillance, 162 were cured, 25 cases turned better, 1 case of death and other 18 cases left hospital without been cured. Conclusion: The pathogens of multiple drug-resistant bacteria are mainly gram-negative bacteria and resistant to most antibiotics in NICU in our hospital. |
| Key words: neonatal intensive care unit multiple drug resistance infection |
