新生儿木糖氧化无色杆菌败血症临床特征及耐药性分析

摘要

Objective To investigate outbreak of Achromobacter xylosoxidans in neonatesand present clinical and laboratory data of the patients. Methods All the neonates with bacteremia due to Achromobacter xylosoxidansfrom Mar 2012 to Dec 2013 were retrospectively analyzed. Results Eighteen episodes of bacteremia occurred in 13 neonates. All neonates were preterm newborns and 61.5%(8/13) had birth weight<1000 g. Prematurity, total parenteral nutrition, previous broad spectrum antibiotic therapy and umbilical venous catheter use were predisposing factors. Prematurity and respiratory distress syndrome were the most common diagnosis at admission. The frequent features were thrombocytopenia, abdominal distention, neutropenia and apnea. Three (23.1%) episodes were breakthrough infections. All isolates were susceptible to Trimethoprim-sulfametoxazole and Meropenem, but showed varied susceptibility to other antibiotics. Conclusions Achromobacter xylosoxidans has potential risk of serious infections in neonate, inviting close attention to early diagnosis. Timely and accurate susceptibility testing and conside-ration for predisposing factors could help to control neonatal bacteremia.%目的：探讨新生儿木糖氧化无色杆菌败血症的临床特征及耐药性。方法回顾性分析2012年3月至2013年12月间，发生木糖氧化无色杆菌败血症新生儿的临床资料。结果研究期间共13例患儿发生18次木糖氧化无色杆菌败血症，3例(23.1%)为暴发性感染。所有患儿均早产，8例(61.5%)出生体质量<1000 g。早产、全肠外营养、接受广谱抗菌药物治疗和脐静脉导管留置是诱发原因。早产合并呼吸窘迫综合征是最主要的诊断。常见的临床特征为血小板减少、腹胀、中性粒细胞减少和呼吸暂停。所有临床分离株对复方新诺明和美罗培南敏感，对其他抗菌药物的敏感性存在差异。结论木糖氧化无色杆菌具有潜在的引起严重院内新生儿感染的风险，准确及时的药敏分析，同时兼顾不同新生儿的基础病情，可使新生儿败血症得到良好控制。