新生儿血液标本分离菌株的种类及耐药性分析

摘要

目的 了解新生儿血培养细菌分布及其耐药性情况.方法 对2006年1月1日-2010年12月31日在安徽医科大学第一附属医院住院的新生儿血培养结果进行回顾性分析.应用WHONET 5.4软件进行统计分析.结果 5年共收集新生儿血液标本分离菌215株,其中革兰阳性球菌占66.1％(142/215),革兰阴性菌占24.2％(52/215),真菌占9.8％(21/215).最常见的分离菌依次为凝固酶阴性葡萄球菌42.3％(91/215)、肺炎克雷伯菌16.7％(36/215)、肠球菌16.3％(35/215)和白念珠菌9.8％(18/215).甲氧西林耐药的金葡菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)分别占各自菌种的18.2％(2/11)和68.1％(62/91).未发现万古霉素、替考拉宁和利奈唑胺耐药菌株.肺炎克雷伯菌产ESBLs株占94.4％(34/36),6株大肠埃希菌产ESBLs(6/7),未发现碳青霉烯类抗生素耐药株.结论 新生儿血液标本主要分离菌以凝固酶阴性葡萄球菌最为常见.细菌多重耐药现象严重.%Objective To investigate the distribution and antimicrobial resistance of microorganisms isolated from blood specimens in newborns. Methods The results of blood culture in the newborns treated in our hospital from January 2006 to December 2010 were reviewed retrospectively. The data were analyzed with WHONET 5. 4 software. Results A total of 215 bacterial strains were collected in the last 5 years. Gram-positive cocci, gram-negative bacilli and fungus account for 66. 1 % (142/215), 24. 2% (52/215) and 9. 8% (21/215) , respectively. The isolates were mainly coagulase-negative Staphylococcus (42. 3%, 91/ 215), K. Pneumoniae (16.7%, 36/215), Enterococcus (16.3%, 35/215) and C. Albicans (9.8%, 18/215). The prevalence of MRSA and MRCNS were 18. 2% and 68. 1% , respectively. No staphylococcal or enterococcal strain was resistant to vancomycin, teicoplanin or linezolid. ESBLs-producing strains were identified in 94. 4% (34/36) of K. Pneumoniae and 6 strains of E. Coli (6/7). No strain of K. Pneumoniae or E. Coli was found resistant to carbapenem. Conclusions Coagulase-negative Staphylococcus is the main isolate from blood culture in newborns. Multi-drug resistance is serious in these isolates.