2010至2014年我院新生儿肺炎主要病原菌分布及耐药性变迁

发布时间：2018-11-16 08:54

【摘要】：目的:探讨我院2010年1月至2014年12月新生儿肺炎的病原菌分布及耐药性变迁,明确本地区病原菌特点,指导临床合理选药。方法:回顾性分析我院2010年1月至2014年12月新生儿痰标本细菌培养及药敏结果。结果:5年共检出病原菌4 310株,其中革兰阴性菌3 722株(86.4%),革兰阳性菌556株(12.9%),真菌32株(0.7%);产ESBLs菌1061株(32.2%),MRSA 37株(7.9%)。各年主要细菌构成变化不大,依次为肺炎克雷伯菌(1216株,28.2%)、大肠埃希菌(859株,19.9%)、金黄色葡萄球菌(469株,10.9%)、阴沟肠杆菌(435株,10.1%)及鲍曼不动杆菌(432株,10.0%);各年产酶率略有变化,而MRSA检出率比较无差异。主要革兰阴性菌对常用抗菌药物的耐药性呈波动性变化,其中肺炎克雷伯菌和大肠埃希菌的耐药性有下降趋势;总体对大部分β-内酰胺酶类高度耐药,对阿米卡星、碳青霉烯类高度敏感。金黄色葡萄球菌各年的耐药率无差异,未发现耐糖肽类及利奈唑胺的菌株。结论:新生儿肺炎的主要病原菌为革兰阴性菌(尤其是肺炎克雷伯菌和大肠埃希菌),因时间差异,细菌对不同抗菌药物的耐药性不同。虽近5年各主要病原菌的耐药性呈下降趋势,但产ESBLs检出率仍较高,且已分离出耐碳青霉烯类的肠杆菌。
[Abstract]:Objective: to investigate the distribution and drug resistance of pathogenic bacteria in neonatal pneumonia from January 2010 to December 2014 in our hospital. Methods: bacterial culture and drug sensitivity of sputum samples from neonates in our hospital from January 2010 to December 2014 were analyzed retrospectively. Results: a total of 4 310 strains of pathogenic bacteria were detected in 5 years, including 3 722 (86. 4%) Gram-negative bacteria, 556 (12. 9%) Gram-positive bacteria and 32 (0. 7%) fungi. There were 1061 strains of ESBLs producing bacteria (32.2%), MRSA 37 strains, 7.9%). The major bacterial composition of each year was not changed, followed by Klebsiella pneumoniae (1216 strains, 28.2%), Escherichia coli (859 strains, 19.9%), Staphylococcus aureus (469 strains, 10.9%), Enterobacter cloacae (435 strains), Enterobacter cloacae (1216 strains), Escherichia coli (19.9%), Enterobacter cloacae ( Acinetobacter baumannii (432 strains, 10.0%); There was a slight change in the rate of enzyme production in each year, but there was no difference in the detection rate of MRSA. The resistance of major gram-negative bacteria to common antimicrobial agents fluctuated, and the resistance of Klebsiella pneumoniae and Escherichia coli decreased. It is highly resistant to most 尾-lactamases and highly sensitive to amikacin and carbapenes. The resistance rate of Staphylococcus aureus was not different from year to year, and no glycopeptide and linazolamide resistant strains were found. Conclusion: the main pathogens of neonatal pneumonia are Gram-negative bacteria (especially Klebsiella pneumoniae and Escherichia coli). Although the drug resistance of the main pathogens decreased in the past five years, the detection rate of ESBLs production was still high, and Enterobacterium resistant to carbapenem had been isolated.
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