早发型与晚发型新生儿败血症病原菌分布及药敏分析
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摘要
目的了解医院新生儿败血症早发型与晚发型病原菌分布及药敏情况,为临床抗生素的使用提供依据。方法选择医院新生儿病房2011年1月-2016年6月收治的158例血培养阳性早发型和晚发型败血症患儿的临床资料,并对引起败血症病原菌的分布及药敏情况进行回顾分析。结果 56例早发型败血症病原菌以大肠埃希菌、凝固酶阴性葡萄球菌、B群链球菌为主,102例晚发型败血症病原菌以凝固酶阴性葡萄球菌、金黄色葡萄球菌、大肠埃希菌为主。葡萄球菌属对青霉素类、头孢菌素类等抗生素耐药率高,对万古霉素、替考拉宁、利奈唑胺等抗生素敏感。B群链球菌对青霉素、万古霉素敏感,对红霉素、阿奇霉素、四环素耐药率高。结论新生儿早发型与晚发型败血症病原菌分布不同,临床应根据药敏结果合理选用抗生素治疗新生儿败血症。
Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from early-onset neonatal sepsis(EONS) and late-onset neonatal sepsis(LONS) in newborn in our hospital, in order to provide evidence for prevention and therapy. Methods The clinical data was collected from 158 cases of EONS and LONS with positive blood culture from January 2011 to June 2016. And the distribution and antibiotic resistance of the pathogen causing sepsis were conducted for retrospective analysis. Results The bacteria causing 56 cases of EONS mainly included Escherichia coli, Coagulase negative Staphylococcus(CNS) and group B Streptococcus. The bacteria causing 102 cases of LONS mainly included CNS, Staphylococcus aureus and Escherichia coli. Staphylococcus is highly resistant to antibiotics such as penicillins and cephalosporins, and is sensitive to antibiotics such as vancomycin, teicoplanin and linezolid. Group B Staphylococcus is sensitive to penicillin and vancomycin, and has high resistance to erythromycin, azithromycin and tetracycline. Conclusion The distribution of pathogenic bacteria was inconsistent in EONS and LONS. Therefore, antibiotics shall be applied based on specific conditions in clinic.
Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from early-onset neonatal sepsis(EONS) and late-onset neonatal sepsis(LONS) in newborn in our hospital, in order to provide evidence for prevention and therapy. Methods The clinical data was collected from 158 cases of EONS and LONS with positive blood culture from January 2011 to June 2016. And the distribution and antibiotic resistance of the pathogen causing sepsis were conducted for retrospective analysis. Results The bacteria causing 56 cases of EONS mainly included Escherichia coli, Coagulase negative Staphylococcus(CNS) and group B Streptococcus. The bacteria causing 102 cases of LONS mainly included CNS, Staphylococcus aureus and Escherichia coli. Staphylococcus is highly resistant to antibiotics such as penicillins and cephalosporins, and is sensitive to antibiotics such as vancomycin, teicoplanin and linezolid. Group B Staphylococcus is sensitive to penicillin and vancomycin, and has high resistance to erythromycin, azithromycin and tetracycline. Conclusion The distribution of pathogenic bacteria was inconsistent in EONS and LONS. Therefore, antibiotics shall be applied based on specific conditions in clinic.
引文
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[12] Chen JM,Chen MH,Yang WN.Early onset listeriosis in prematurty[J].Acta Paediatr Tw,2003,44(2):106-108.
[13] 宋丹,张亚昱,梅花.B族链球菌感染与早产儿相关性研究进展[J].临床儿科杂志,2015,33(12):1065-1067.
[14] 沈艳华,刘红,齐宇洁,等.新生儿B族链球菌败血症的临床研究[J].山西医科大学学报,2016,47(11):1041-1045.
[15] 潘千,余加林.新生儿早发型B组链球菌感染的预防和管理[J].儿科药学杂志,2016,22(11):48-52.
[2] 吴仕孝,余加林.新生儿败血症诊疗方案[J].中华儿科杂志,2003,41(12):897-899.
[3] 卢江溢,李禄全.新生儿早发型败血症诊断进展[J].临床儿科杂志,2015,33(9):822-826.
[4] 余加林.新生儿败血症的诊断和治疗[J].实用儿科临床杂志,2005,20(2):100-102.
[5] 岳冬梅,佟雅洁,崔金龙.NICU新生儿败血症病原菌分布及其耐药性分析[J].实用药物与临床,2016,19(11):1427-1430.
[6] 杨锡强,易著文,沈晓明,等.儿科学[M].6版.北京:人民卫生出版社,2004:141-143.
[7] 柏进,杨娟,韩雪花,等.新生儿败血症早发型与晚发型病原菌及其药敏分析[J].山东医药,2010,50(17):99-100.
[8] 贾忠兰,毕福玲,张彩明.新生儿败血症病原菌分布及耐药性分析[J].中华医院感染学杂志,2017,27(1):197-200.
[9] 张伟新.早发型和晚发型新生儿败血症的临床特点和病原菌分析[J].广东医科大学学报,2017,35(1):62-64.
[10] 刘志伟,唐征,丁艳,等.新生儿早发型与晚发型败血症临床特征[J].临床儿科杂志,2011,29(5):446-449.
[11] Stol B,Hansen NJ,Sanchez P,et al.Early onset neonatal sepsis:the burden of group B streptococcal and E.coli disease continues[J].Predistrics,2011,127(5):817-826.
[12] Chen JM,Chen MH,Yang WN.Early onset listeriosis in prematurty[J].Acta Paediatr Tw,2003,44(2):106-108.
[13] 宋丹,张亚昱,梅花.B族链球菌感染与早产儿相关性研究进展[J].临床儿科杂志,2015,33(12):1065-1067.
[14] 沈艳华,刘红,齐宇洁,等.新生儿B族链球菌败血症的临床研究[J].山西医科大学学报,2016,47(11):1041-1045.
[15] 潘千,余加林.新生儿早发型B组链球菌感染的预防和管理[J].儿科药学杂志,2016,22(11):48-52.