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目的:掌握新生儿败血症病原菌的流行分布及耐药情况,指导临床合理使用抗生素。方法:回顾性分析2006年1月~2011年5月广西壮族自治区妇幼保健院新生儿病房血培养阳性的121例败血症患儿的感染菌株及药物敏感情况。按照发病时间分为早发型败血症(出生3天内发病)及晚发型败血症(出生3天后发病),晚发型败血症根据发生感染的地点分为社区获得性感染和院内感染。结果:早发型败血症50例,病原菌以革兰阴性杆菌为主(40例,感染率为80.0%),其中产ESBLS株5例;革兰阳性凝固酶阴性葡萄球菌10例,感染率为20.0%。晚发型败血症71例,其中社区感染56例,院内感染15例。社区感染中革兰阳性球菌30例(42.2%),革兰阴性杆菌26例(36.6%)。院内感染革兰阴性杆菌7例(9.9%),其中产ESBLS株4例;真菌8例,为白色念珠菌,感染率11.2%。结论:早发型败血症、社区获得性败血症、院内感染导致的败血症病原谱不同,有多重耐药菌产生。
Objective: To master the epidemic distribution and drug resistance of neonatal sepsis pathogens, to guide the rational use of antibiotics in clinical practice. Methods: The clinical isolates and drug susceptibility of 121 septicemia children with positive blood culture in neonatal ward of MCH from January 2006 to May 2011 were retrospectively analyzed. According to the onset time is divided into early-onset sepsis (onset within 3 days of birth) and late-onset sepsis (onset 3 days after birth), late-onset sepsis according to the location of infection is divided into community-acquired infections and nosocomial infections. Results: There were 50 cases of early onset septicemia, mainly Gram-negative bacilli (40 cases, the infection rate was 80.0%), ESBLS strain was 5 cases, Gram-positive coagulase negative staphylococcus was 10 cases, the infection rate was 20.0% . 71 cases of late-onset sepsis, including 56 cases of community-based infection, 15 cases of nosocomial infection. Gram-positive cocci in community infection in 30 cases (42.2%), Gram-negative bacilli in 26 cases (36.6%). There were 7 cases (9.9%) of Gram-negative bacilli in hospital, of which ESBLS strains were found in 4 cases and 8 fungi were Candida albicans with infection rate of 11.2%. Conclusion: Early onset sepsis, community-acquired septicemia, sepsis caused by nosocomial infections have different pathogenic spectrum, and multiple drug-resistant bacteria are produced.