新生儿大肠埃希菌化脓性脑膜炎临床特点及耐药性分析

发布时间：2018-11-11 16:26

【摘要】：目的了解新生儿大肠埃希菌化脓性脑膜炎的临床特点及耐药性情况。方法回顾性分析2004年6月—2014年6月收治的46例新生儿大肠埃希菌化脓性脑膜炎的临床资料,46例新生儿分为社区感染组和院内感染组,以及2004年6月—2009年5月的早期组和2009年6月—2014年6月的晚期组,分别比较临床表现及产超广谱β内酰胺酶(ESBLs)检出率和药敏试验结果。结果患儿均以发热或体温不升,反应差,少吃或拒乳,呼吸、心率增快为临床表现。院内感染组ESBLs检出率明显高于社区感染组,晚期组ESBLs检出率明显高于早期组,差异均有统计学意义(P??0.05)。院内感染组对常用的头孢菌素类抗生素耐药性明显高于社区感染组,晚期组对常用的青霉素类、头孢菌素类抗生素耐药性明显高于早期组,差异均有统计学意义(P??0.05)。结论新生儿大肠埃希菌化脓性脑膜炎临床表现不典型,近年来大肠埃希菌对青霉素类及头孢菌素类抗生药物的耐药性显著上升,院内感染是获得ESBLs的高危因素。
[Abstract]:Objective to investigate the clinical characteristics and drug resistance of neonatal Escherichia coli suppurative meningitis. Methods the clinical data of 46 neonates with Escherichia coli suppurative meningitis admitted from June 2004 to June 2014 were retrospectively analyzed. 46 newborns were divided into community infection group and hospital infection group. The clinical manifestations, the detection rate of extended-spectrum 尾 -lactamase (ESBLs) and the results of drug sensitivity test were compared between the early group from June 2004 to May 2009 and the late group from June 2009 to June 2014. Results the clinical manifestations were fever or no rise in body temperature, poor response, low consumption or rejection of milk, respiration and heart rate increase. The detection rate of ESBLs in nosocomial infection group was significantly higher than that in community infection group, and the detection rate of ESBLs in late stage group was significantly higher than that in early group (P < 0. 05). The drug resistance of nosocomial infection group to commonly used cephalosporins was significantly higher than that of community infection group, and the resistance to penicillin and cephalosporin antibiotics in late stage group was significantly higher than that in early group. The difference was statistically significant (P < 0.05). Conclusion the clinical manifestations of neonatal suppurative meningitis of Escherichia coli are not typical. The resistance of Escherichia coli to penicillin and cephalosporins has increased significantly in recent years. Nosocomial infection is a high risk factor for obtaining ESBLs.
【作者单位】：浙江丽水市中心医院;
【分类号】：R446.5;R722.1

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