| 摘要: |
| 目的：对我院1 538例新生儿肺炎痰液标本的主要病原菌分布及耐药性进行分析，了解泸州地区病原分布及耐药病原菌特点。方法：回顾性分析我院2013年7月至2016年12月新生儿痰液标本病原菌培养及药敏结果。结果：（1）1 538例痰培养标本培养阳性1 216例，阳性率79.06%。1 216例痰标本培养正常菌群489株，异常细菌705株，真菌22株。（2）最常见的G-菌为肺炎克雷伯杆菌144株（20.43%），大肠埃希菌118株（16.74%），铜绿假单胞菌40株（5.67%），阴沟肠杆菌34株（4.82%）；G+菌主要为金黄色葡萄球菌124株（17.59%），肺炎链球菌9株（1.28 %）。22株真菌均为白色念珠菌。（3）G-菌中的肺炎克雷伯杆菌对合成青霉素类耐药性较高（氨苄西林89.58%，哌拉西林69.44%)，头孢菌素类抗生素其次（头孢唑林56.25%，头孢呋辛50%，头孢吡肟47.91%），对碳青霉烯类高度敏感。铜绿假单胞菌对亚胺培南（80.00%）、哌拉西林（77.50%）、头孢吡肟（72.5%）耐药，对厄他培南高度敏感。G+菌中金黄色葡萄球菌和肺炎链球菌对万古霉素、利奈唑胺高度敏感，对合成青霉素类及头孢类抗生素耐药率16%~29%。（4）早产儿共583例，胎龄（32.00±2.17）周，检测出病原菌223株（31.63%，223/705），以肺炎克雷伯杆茵（6.10%，43/705）、超广谱β内酰胺酶（ESBL）菌株（6.10%，43/705），大肠埃希菌（5.81%，41/705）为主；新生儿重症监护病房（NICU）患儿359例致病菌培养阳性，前3位是肺炎克雷伯杆茵（9.64%）、ESBL菌株（9.50%）、金黄色葡萄球菌（7.09%）。结论：本地区新生儿肺炎的主要病原菌为革兰阴性菌主要是肺炎克雷伯杆菌及大肠埃希菌，各种细菌对抗生素的耐药性有差异 |
| 关键词: 新生儿 肺炎 病原菌 耐药性 抗菌药物 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2020.11.014 |
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| 基金项目: |
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| Distribution and Drug Resistance of Main Pathogens in 1,538 Cases of Neonatal Pneumonia |
| Zhu Shuai, Chen Zhi, Jiang Qing, Cao Xiaolan, Chen Ai |
| (The Affiliated Hospital of Southwest Medical University, Sichuan Luzhou 646000, China) |
| Abstract: |
| Objective: To analyze the distribution and drug resistance of main pathogens in the sputum samples of 1,538 cases of neonatal pneumonia, and to investigate the distribution of pathogens and the characteristics of drug-resistant pathogens in Luzhou. Methods: Retrospective analysis was performed on pathogens culture and drug sensitivity results of neonatal sputum samples from Jul. 2013 to Dec. 2016 in our hospital. Results: (1) Of the 1,538 cases, sputum culture specimens were positive in 1,216 cases, with a positive rate of 79.06%. The sputum specimens from 1,216 cases were cultured with 489 normal strains, 705 abnormal strains and 22 fungal strains. (2) The main G- bacteria pathogens were 144 strains of Klebsiella pneumoniae (20.43%), followed by 118 strains of Escherichia coli (16.74%), 40 strains of Pseudomonas aeruginosa (5.67%), and 34 strains of Enterobacter cloacae (4.82%, 34/705). Top ranking G+ bacteria were 124 strains of Staphylococcus aureus (17.59%) and 9 strains of Streptococcus pneumoniae (1.28%). The fungus was 22 strains of Candida albicans. (3) Klebsiella pneumoniae had higher resistance to synthetic penicillin (ampicillin 89.58%, piperacillin 69.44%), followed by cephalosporin antibiotics (cefazolin 56.25%, cefuroxime 50%, cefepime 47.91%), which was highly sensitive to carbapenems. P. aeruginosa was resistant to imipenem (80.00%), piperacillin (77.50%), cefepime (72.50%), and highly sensitive to ertapenem. S. aureus and Streptococcus pneumoniae in G+ bacteria were highly sensitive to vancomycin and linezolid, and the resistance rates to synthetic penicillins and cephalosporins were from 16% to 29%. (4) There were 223 pathogens (31.63%) detected in 583 premature infants with gestational age leveled (32.00±2.17) weeks, K. pneumoniae (6.10%, 43/705), extended-spectrum β-lactamase (ESBL) strains (6.10%, 43/705) and E. coli (5.81%, 41/705) were the main strains. There were 359 positive pathogens in neonatal intensive care unit (NICU) children, the top three were K. pneumoniae (9.64%), ESBL strains (9.50%) and S. aureus (7.09%). Conclusion: The main pathogens of neonatal pneumonia in this region are G- bacteria, especially K. pneumoniae and E. coli, and the resistance of various bacteria to antibiotics is different. |
| Key words: neonates pneumonia pathogens drug resistance antibiotics |
