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目的分析新生儿病房血培养标本来源病原菌分布及药敏状况,为临床合理使用抗菌药物提供依据。方法回顾南方医科大学附属佛山市妇幼保健院新生儿科2010-2014年全部血培养标本结果,常规方法培养分离血标本中的细菌,用MIC法测定细菌药物敏感性,所有数据使用WHONET 5.6进行汇总分析。结果血标本来源分离出细菌406株,前5位菌种为表皮葡萄球菌(39.90%)、溶血葡萄球菌(10.10%)、无乳链球菌(8.13%)、大肠埃希菌(8.13%)及肺炎克雷伯菌(7.39%)。葡萄球菌对青霉素的耐药率为100.00%,凝固酶阴性葡萄球菌对苯唑西林的耐药率>85.00%,金黄色葡萄球菌对苯唑西林的耐药率为25.00%,对万古霉素、替考拉宁敏感,未检出耐万古霉素金黄色葡萄球菌;无乳链球菌对青霉素、万古霉素敏感;大肠埃希菌和肺炎克雷伯菌对氨苄西林、哌拉西林等常见抗菌药物耐药率高,对碳青霉烯类、喹诺酮类及阿米卡星敏感,对三代、四代头孢菌素、氨曲南、复方磺胺等抗菌药物产生了不同的耐药性。结论 2010-2014年该院新生儿科血培养标本以革兰氏阳性球菌为主,大肠埃希菌和肺炎克雷伯菌是主要的革兰氏阴性菌且对部分抗菌药物的耐药性有差异。临床医生应结合本地近年来病原菌及耐药特点给予合理治疗,并根据培养结果进行调整。
Objective To analyze the distribution of pathogens and drug susceptibility in neonatal ward blood culture samples and provide basis for rational use of antimicrobial agents in clinic. Methods The results of whole blood culture samples from 2010 to 2014 in Department of Neonatology, Foshan Maternal and Child Health Hospital Affiliated to Southern Medical University were retrospectively analyzed. Bacteria were separated from blood samples by routine method. Susceptibility to bacteria was determined by MIC method. All the data were analyzed by WHONET 5.6 . Results 406 strains of bacteria were isolated from blood samples. The first 5 strains were Staphylococcus epidermidis (39.90%), Staphylococcus haemolyticus (10.10%), Streptococcus agalactiae (8.13%), Escherichia coli Klebsiella pneumoniae (7.39%). Staphylococcus aureus penicillin resistance rate was 100.00%, coagulase-negative staphylococcus oxacillin resistance rate was> 85.00%, Staphylococcus aureus resistance to oxacillin rate was 25.00%, vancomycin, Teicoplanin sensitive, not detected vancomycin-resistant Staphylococcus aureus; Streptococcus agalactiae on penicillin, vancomycin-sensitive; Escherichia coli and Klebsiella pneumoniae on ampicillin, piperacillin and other common antibacterial Drug resistance rate is high, to carbapenems, quinolones and amikacin sensitivity, on the third and fourth generation cephalosporins, aztreonam, sulfamethoxazole and other antimicrobial drugs have different resistance. CONCLUSIONS: Neonatal pediatric blood culture specimens from 2010 to 2014 mainly include Gram-positive cocci, while Escherichia coli and Klebsiella pneumoniae are the major Gram-negative bacteria and have different drug resistance to some antibiotics . Clinicians should be combined with local pathogens and drug resistance in recent years to give reasonable treatment, and adjusted according to the results of the culture.