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新生儿败血症临床致病菌的分布及其对抗菌药物的耐药性分析及治疗策略

Analysis on Distribution and Drug Resistance of Clinical Pathogens of Neonatal Septicemia and Its Treatment Strategies
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摘要 目的:分析新生儿败血症临床致病菌的分布及其对抗菌药物的耐药性及治疗策略,为初始经验性治疗药物的选用提供参考。方法:抽取2015年1月-2018年10月间收治的新生儿ICU新生儿败血症患者81例临床资料,分析血菌培养及其药敏结果。结果:81例新生儿败血症患者血液样本中分离出81株致病菌,其中革兰阴性菌12株占14.81%和革兰阳性菌69株占85.19%;药敏试验结果显示,革兰阴性菌对氨苄西林耐药,而对亚胺培南、阿米卡星和哌拉西林-他唑巴坦高度敏感;革兰阳性菌以表皮葡萄球菌和金黄色葡萄球菌为主,其对万古霉素和利奈唑胺敏感性为100.00%,而对青霉素类、红霉素均显著耐药;在迟发型新生儿败血症的61株病原菌中,表皮葡萄球菌占29.63%。结论:迟发型新生儿败血症患者检出病原菌主要为表皮葡萄球菌和金黄色葡萄球菌,建议可经验性选用万古霉素或利奈唑胺治疗。 Objective: To analyze the distribution of clinical pathogenic bacteria of neonatal septicemia and their antimicrobial resistance as well as treatment strategies, and to provide a reference for the selection of drugs for initial empirical treatment. Methods: Clinical data of 81 neonatal septicemia patients admitted to the neonatal ICU from January 2015 to October 2018 were extracted, and blood bacterial culture and drug sensitivity results were analyzed. Results: 81 pathogenic bacteria were isolated from 81 cases of neonatal septicemia, among which 12 strains of Gram-negative bacteria accounted for 14.81% and 69 strains of Gram-positive bacteria accounted for 85.19%. The results of drug sensitivity test showed that the Gram-negative bacteria were resistant to ampicillin but highly sensitive to imipenem, amikacin and piperacilin-tazobactam. Gram-positive bacteria were mainly Staphylococcus epidermidis and Staphylococcus aureus, with a sensitivity of 100.00% to vancomycin and linezolid, and significant resistance to penicillin and erythromycin.Staphylococcus epidermidis accounted for 29.63% of 61 strains of delayed neonatal septicemia. Conclusion: The main pathogenic bacteria detected in delayed neonatal septicemia patients were Staphylococcus epidermidis and Staphylococcus aureus.
作者 王光勇 陈永刚 周彬 尚振海 WANG Guang-yong;CHEN Yong-gang;ZHOU Bin;SHANG Zhen-hai(Xuzhou Central Hospital, Xuzhou Jiangsu 221000, China;The Hospital Affiliated to Xuzhou Medical University, Xuzhou Jiangsu 221000, China)
出处 《抗感染药学》 2019年第4期590-594,共5页 Anti-infection Pharmacy
关键词 新生儿 败血症 病原菌株 耐药性 治疗策略 neonatal septicemia pathogenic strain drug resistance treatment strategies
作者简介 王光勇(1970—),男,副主任药师;通信作者:陈永刚(1982—),男,主管药师,联系电话:18952170679,E-mail:18952170679@163.com.
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