新生儿重症监护室病原菌监测及耐药性分析

摘要

OBJECTIVE:To investigate the distribution and drug resistance of pathogenic bacterial in neonatal intensive care unit(NICU), and to provide evidence for rational use of antibiotics in clinic.METHODS:The distribution and drug resistance of the pathogenic bacterial isolated from 3 802 specimens in NICU of the hospital from Jan.to Dec.2013 were retrospectively analyzed.RESULTS: 308 strains of pathogenic bacterial were isolated from 3 802 specimens, with the isolation rate of 8.10%, among which the gram-positive cocci accounted for 54.22%;staphylococcus epidermidis took the lead(17.86%), followed by staphylococcus aureus(11.36%)and staphylococcus haemolyticus(7.79%),all of which had high resistance to erythrocin.The proporation of gram-negative bacilli was 45.78%, the top three leading species were the escherichia coli(22.40%), klebsiella pneumoniae (12.01%) and pseudomonas aeruginosa (5.19%).The drug resistance rate of gram-negative bacilli to the third and fourth generation of cephalosporin, aztreonam, broad-spectrum penicillin andβ-lactams with similar structure were all over 40%,but gram-negative bacilli was still sensitive to carbapenems.The multi-drug resistance strain mainly focus on escherichia coli.CONCLUSIONS: With the continuance use of antibiotics, the detection rates of S.epiderm and E.coli are both in high level, therefore, it is necessary to draw the close attention of monitoring operators in nosocomial infection so as to promote the rational drug use in clinic.%目的：分析新生儿重症监护室（neonatal intensive care unit，NICU）病原菌的分布及耐药性，为临床合理应用抗菌药物提供依据。方法：回顾性分析NICU收集的2013年1—12月3802份临床标本分离的病原菌分布及耐药性。结果：3802份标本中，共分离出病原菌株308株，分离率为8.10％。革兰阳性球菌占54.22％，以凝固酶阴性葡萄球菌为主（占17.86％），其次为金黄色葡萄球菌（占11.36％）和溶血性葡萄球菌（占7.79％），对红霉素的耐药性均较高；革兰阴性杆菌占45.78％，前3位依次为大肠埃希菌（占22.40％）、肺炎克雷伯菌（占12.01％）、铜绿假单胞菌（占5.19％），革兰阴性杆菌对第3、4代头孢菌素、氨曲南、广谱青霉素类及结构相似的β-内酰胺类药物耐药率大于40％，对碳青霉烯类仍敏感；多重耐药菌主要为大肠埃希菌氏菌。结论：随着抗菌药物的持续使用，表皮葡萄球菌及大肠埃希菌检出率处于较高水平，应引起院内感染监测人员的密切关注，以促进临床合理用药。