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目的分析新生儿重症监护室(NICU)中肺炎克雷伯菌败血症的危险因素和临床特征,做到早期诊断和合理治疗。方法对我院NICU2005年1月至2008年5月期间16例确诊为肺炎克雷伯菌败血症患儿的临床资料和药敏结果进行回顾性分析,并与同期32例非败血症患儿和33例其他病原体所致败血症患儿进行比较。结果低出生体质量、外周静脉中心静脉置管(PICC)、先期使用3代头孢菌素为肺炎克雷伯菌败血症的危险因素,所有病例均属于医院获得性感染,全部发生在早产儿,81.2%是极低出生体重儿;若同时合并其他致病菌感染预后差;肺炎克雷伯菌93%为产β内酰胺酶(ESBL)菌株,100%对亚胺培南类药物敏感,对常用头孢类药物不敏感。结论肺炎克雷伯菌已成为NICU中败血症的主要致病菌,而且多为医院感染。与早产低出生体质量、PICC、先期使用3代头孢菌素有关,耐药性强,碳青霉烯类是敏感药物。
Objective To analyze the risk factors and clinical characteristics of Klebsiella pneumoniae septicemia in neonatal intensive care unit (NICU) so that early diagnosis and reasonable treatment can be made. Methods The clinical data and drug susceptibility results of 16 NICU patients diagnosed as Klebsiella pneumoniae in our hospital from January 2005 to May 2008 were retrospectively analyzed and compared with 32 non-sepsis children and 33 Other pathogen-induced sepsis in children compared. Results Low birth weight, peripheral venous central venous catheter (PICC), the first use of third generation cephalosporins Klebsiella pneumoniae septicemia risk factors, all cases are hospital-acquired infections, all occurred in preterm children, 81.2 % Is a very low birth weight infants; if the simultaneous infection with other pathogens poor prognosis; Klebsiella pneumoniae 93% to produce β-lactamase (ESBL) strains, 100% of imipenem-sensitive, Cephalosporins are not sensitive. Conclusion Klebsiella pneumoniae has become the main causative agent of sepsis in NICU, and most of them are nosocomial infections. Low birth weight with preterm birth, PICC, early use of third-generation cephalosporins, resistance, carbapenem is a sensitive drug.