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新生儿阑尾炎致病菌药敏及抗菌治疗分析
曹建,侯金平,何昀,刘清爽,郭振华,刘伟
0
(重庆医科大学附属儿童医院,重庆 400014)
摘要:
目的:分析新生儿阑尾炎病原学构成、耐药性变化,为抗菌药物选择提供依据。方法:采集我院近5年11例新生儿阑尾炎腹腔脓液行细菌培养及药敏分析,分析致病菌构成、药敏结果,随访治疗疗效。结果:11例标本分离出细菌12株,革兰阴性菌10株(83.33%),肺炎克雷伯菌6株(50%),产茁鄄内酰胺酶菌6株(50%)。主要致病菌对碳青霉烯类抗生素、阿米卡星、哌拉西林/他唑巴坦敏感率>75%。根据药敏结果制定抗感染方案,1例出现残余感染,治疗有效率为90.91%。结论:新生儿阑尾炎以肺炎克雷伯菌为主,对常见的广谱青霉素及头孢菌素耐药性高。细菌学检查对临床合理使用抗生素、减少耐药菌株形成起到重要作用。
关键词:  阑尾炎  新生儿  细菌培养  药敏实验  抗生素选择
DOI:doi:10.13407/j.cnki.jpp.1672-108X.2018.07.005
基金项目:
Pathogenic Bacteria and Drug Sensitivity Spectrum in Neonatal Appendicitis
Cao Jian, Hou Jinping, He Yun, Liu Qingshuang, Guo Zhenhua, Liu Wei
(Children's Hospital of Chongqing Medical University, Chongqing 400014, China)
Abstract:
Objective: To analyze the etiology and drug resistance in neonatal appendicitis, so as to provide reference for selection of antibiotics. Methods: Eleven cases were collected for bacterial culture and sensitivity test, then the etiology and drug resistance were analyzed, and the treatment efficacy was followed up. Results: Twelve strains of bacteria were isolated from 11 samples, with 10 strains of gram-negative bacteria (83.33%), 6 strains of Klebsiella pneumoniae (50%), 6 strains of spectrum β-lactamase producing bacteria (50%). The sensitivity of the major pathogens to carbapenem antibiotics, amikacin and peracillin/tazobartan were >75%. According to the drug susceptibility results, the anti-infection program was developed, and residual infection was fund in 1 case; the effective rate of the treatment program was 90.91%. Conclusion: The main bacteria of neonatal appendicitis is Klebsiella pneumoniae which has high resistance to the common penicillins and cephalosporins. Bacteriological examination plays an important role in the rational use of antibiotics in clinic and the reduction of drug-resistant strains.
Key words:  appendicitis  neonate  bacterial culture  susceptibility test  selction of antibiotics

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