1606例新生儿败血症病原菌分布及其耐药性分析

摘要

Objective To determine the pathogen profile and antibiotic resistance in aerobic isolates from blood cultures of neonates. Methods All blood culture reports (n=28120) from newborns admitted to the Department of Neonatology during 2002-2012 were analyzed, and the sensitivity patterns were recorded. Results A total of 1665 bacteria were isolated from 1606 blood culture-positive samples and the positive rate of blood cultures was 5.7%(1606/28120). Gram-positive bacteria were iso-lated in 1336 cases, with Staphylococcus epidermidis (902 cases) and Staphylococcus haemolyticus (206 cases) being the com-mon bacteria. Klebsiella pneumoniae (108 cases), followed by Escherichia coli (73 cases), were the major Gram-negative bacte-ria (235 cases). The determination of the antibiotic resistance of aerobic isolates was performed in 2012. Most Gram-positive iso-lates were sensitive to vancomycin and moxifloxacin, and more than 90%were resistant to penicillin while most of Gram-nega-tive isolates were sensitive to amikacin and imipenem. Conclusions Staphylococcus epidermidis, Staphylococcus haemolyticus, Klebsiella pneumoniae and Escherichia coli remain to be the principal organisms responsible for neonatal sepsis.%目的：研究败血症新生儿的病原菌分布及其耐药情况。方法回顾性分析2002年至2012年间收入新生儿重症监护病房的新生儿血培养及其药敏分析结果。结果共28120份新生儿血培养标本中培养阳性1606份（5.7%），共培养出病原菌1665株；其中革兰阳性菌1336株，以表皮葡萄球菌（902株）及溶血性葡萄球菌（206株）为主；革兰阴性菌235株，以肺炎克雷伯杆菌（108株）及大肠埃希菌（73株）为主。逐年比较，不同菌株的检出率差异有统计学意义（P<0.05）。2012年175株病原菌的药敏结果显示，革兰阳性菌对利奈唑胺、替加环素和万古霉素的敏感率高，对青霉素耐药性达90%以上；革兰阴性菌对阿米卡星及亚胺培南敏感性高，对氨苄西林的耐药性较高。结论表皮葡萄球菌、溶血性葡萄球菌、肺炎克雷伯杆菌及大肠埃希菌是新生儿败血症的主要病原菌，且普遍对青霉素耐药。