Clinical Study on Bacterial Colonization and Antibiotic Resistance in Neonatal Intensive Care Unit

摘要

Background:The aim of this study is to investigate bacteria colonization and analyze the antibiotic resistance of the colonized bacteria on newborns in the neonatal intensive care unit(NICU).
　　Methods:A retrospective cohort study was conducted in a university hospital NICU in Wuhan.A total of 307 nasopharyngeal (throat) swabs specimens were done among 186 hospitalized newborn babies from study period (from July 2010 to February 2012).Bacterial prevalence were examined with the method of throat swab culture during hospitalization at least once a week.Clinical data and the result of the bacterial surveillance were collected.Some babies were subjected to more than one throat swab due to their extended stay in NICU and one positive throat swab culture sometimes showed more than one pathogens.
　　Results:Among the 307 specimens collected,105 were positive and 202 were negative.From the 105 positive specimens,131 organisms were isolated with 130 gram negative bacteria and only one gram positive organism.The most colonized organisms in NICU were E.coli(31.3％),Klebsiella pneumoniae(30.5％) and Stenotrophomonas maltophilia(12.2％).The most susceptible antibiotic for the gram negative organisms in NICU were meropenem and imipenem.It was found that gram negative bacteria especially E.coli and Klebsiella pneumoniae were highly resistant to ampicillin,cefuroxime,cefotaxime and piperacillin with drug resistant rates as high as 97.8％,86.0％,83.2％ and 75.4％.However,when a beta lactamase inhibitor (sulbactam,clavulanic acid and tazobactam)is used in combination with another antibiotic,the rate of drug resistance decreased consequently.We investigated the occurrence and drug resistance of extended spectrum beta lactamases.From 41 colonies of E.coli,ESBLs was 100％ and was 90％ for the 40 colonies of Klebsiella pneumoniae.
　　Conclusion:We can conclude that gram negative organisms are more prevalent in the NICU and they are highly resistant to cephalosporins and other beta lactams but susceptible to carbapenems.The knowledge of the organisms prevalent in the NICU and their antibiotic sensitivity is very important and can help the health care workers for the judicious use of antimicrobials in the NICU thus getting the optimum results for prevention of antibiotic resistance and provide referrence of clinical rational antibiotic administration.

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