發(fā)布時(shí)間：2018-11-16 08:54

【摘要】：目的:探討我院2010年1月至2014年12月新生兒肺炎的病原菌分布及耐藥性變遷,明確本地區(qū)病原菌特點(diǎn),指導(dǎo)臨床合理選藥。方法:回顧性分析我院2010年1月至2014年12月新生兒痰標(biāo)本細(xì)菌培養(yǎng)及藥敏結(jié)果。結(jié)果:5年共檢出病原菌4 310株,其中革蘭陰性菌3 722株(86.4%),革蘭陽(yáng)性菌556株(12.9%),真菌32株(0.7%);產(chǎn)ESBLs菌1061株(32.2%),MRSA 37株(7.9%)。各年主要細(xì)菌構(gòu)成變化不大,依次為肺炎克雷伯菌(1216株,28.2%)、大腸埃希菌(859株,19.9%)、金黃色葡萄球菌(469株,10.9%)、陰溝腸桿菌(435株,10.1%)及鮑曼不動(dòng)桿菌(432株,10.0%);各年產(chǎn)酶率略有變化,而MRSA檢出率比較無(wú)差異。主要革蘭陰性菌對(duì)常用抗菌藥物的耐藥性呈波動(dòng)性變化,其中肺炎克雷伯菌和大腸埃希菌的耐藥性有下降趨勢(shì);總體對(duì)大部分β-內(nèi)酰胺酶類高度耐藥,對(duì)阿米卡星、碳青霉烯類高度敏感。金黃色葡萄球菌各年的耐藥率無(wú)差異,未發(fā)現(xiàn)耐糖肽類及利奈唑胺的菌株。結(jié)論:新生兒肺炎的主要病原菌為革蘭陰性菌(尤其是肺炎克雷伯菌和大腸埃希菌),因時(shí)間差異,細(xì)菌對(duì)不同抗菌藥物的耐藥性不同。雖近5年各主要病原菌的耐藥性呈下降趨勢(shì),但產(chǎn)ESBLs檢出率仍較高,且已分離出耐碳青霉烯類的腸桿菌。
[Abstract]:Objective: to investigate the distribution and drug resistance of pathogenic bacteria in neonatal pneumonia from January 2010 to December 2014 in our hospital. Methods: bacterial culture and drug sensitivity of sputum samples from neonates in our hospital from January 2010 to December 2014 were analyzed retrospectively. Results: a total of 4 310 strains of pathogenic bacteria were detected in 5 years, including 3 722 (86. 4%) Gram-negative bacteria, 556 (12. 9%) Gram-positive bacteria and 32 (0. 7%) fungi. There were 1061 strains of ESBLs producing bacteria (32.2%), MRSA 37 strains, 7.9%). The major bacterial composition of each year was not changed, followed by Klebsiella pneumoniae (1216 strains, 28.2%), Escherichia coli (859 strains, 19.9%), Staphylococcus aureus (469 strains, 10.9%), Enterobacter cloacae (435 strains), Enterobacter cloacae (1216 strains), Escherichia coli (19.9%), Enterobacter cloacae ( Acinetobacter baumannii (432 strains, 10.0%); There was a slight change in the rate of enzyme production in each year, but there was no difference in the detection rate of MRSA. The resistance of major gram-negative bacteria to common antimicrobial agents fluctuated, and the resistance of Klebsiella pneumoniae and Escherichia coli decreased. It is highly resistant to most 尾-lactamases and highly sensitive to amikacin and carbapenes. The resistance rate of Staphylococcus aureus was not different from year to year, and no glycopeptide and linazolamide resistant strains were found. Conclusion: the main pathogens of neonatal pneumonia are Gram-negative bacteria (especially Klebsiella pneumoniae and Escherichia coli). Although the drug resistance of the main pathogens decreased in the past five years, the detection rate of ESBLs production was still high, and Enterobacterium resistant to carbapenem had been isolated.
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本文編號(hào)：2335076