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目的:分析新生儿无乳链球菌(GBS)败血症患者的临床特点及其抗菌治疗用药情况,为临床合理用药提供参考。方法:采用回顾性分析法,分析2013年3月—2015年3月间新生儿病房收治的19例GBS败血症患儿的临床资料、治疗和预后以及GBS菌株的敏感性。结果:19例GBS败血症患儿中,15例为早发型,4例为晚发型;合并症肺炎者为14例(早发感染者为13例),化脓性脑膜炎者为4例(晚发感染者为3例);经细菌培养示青霉素、氨苄青霉素、头孢曲松和万古霉素对该菌较敏感,而该菌对克林霉素、红霉素和左氧氟沙星的耐药率依次为73.08%,65.38%和42.31%以及对利奈唑胺的耐药率为3.85%。结论:新生儿GBS菌株对多种抗菌药物的耐药率较高,临床上应首选青霉素、头孢菌素和万古霉素等对其敏感的抗菌药物;对于合并化脓性脑膜炎患儿,应及早积极给予易透过血脑屏障的抗菌药物治疗。
Objective: To analyze the clinical features of antibiotics and antibiotic treatment in patients with neonatal Streptococcus agalactiae (GBS) sepsis and provide a reference for clinical rational drug use. Methods: The clinical data, treatment and prognosis of 19 children with GBS sepsis treated in neonatal ward from March 2013 to March 2015 were analyzed retrospectively. The sensitivity of GBS strains was also analyzed. Results: Of the 19 GBS sepsis children, 15 were early-onset and 4 were late-onset; 14 were pneumoconiosis (13 for early-onset infection) and 4 were for purulent meningitis Infected with 3 cases); penicillin, ampicillin, ceftriaxone and vancomycin were sensitive to the bacteria by bacterial culture, and the resistance rate to clindamycin, erythromycin and levofloxacin was 73.08 %, 65.38% and 42.31% respectively, and the resistance rate to linezolid was 3.85%. CONCLUSIONS: Neonatal GBS strains have a high resistance rate to various antimicrobial agents. Clinically, penicillins, cephalosporins and vancomycin should be the first choice for antibacterial drugs. For children with purulent meningitis, Actively give antimicrobial drugs that are easily cross the blood-brain barrier.