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目的探讨近年来新生儿大肠埃希菌败血症的临床特点及耐药性变迁情况,为早期诊断及合理治疗提供依据。方法对2002年1月至2008年10月本院确诊的40例新生儿大肠埃希菌败血症的临床资料及药敏结果进行回顾性分析。结果新生儿大肠埃希菌败血症临床表现多样,以发热、黄疸等表现多见,75.7%的病例C反应蛋白异常。40例新生儿大肠埃希菌败血症中有12例并发化脓性脑膜炎。大肠埃希菌对阿米卡星、环丙沙星、头孢西丁的耐药率低,对亚胺培南未发现耐药,对常用的头孢菌素耐药及产超广谱β内酰胺酶率近年有明显增高趋势。同时大肠埃希菌所致的晚发型败血症较早发型者耐药率高。结论新生儿大肠埃希菌败血症临床表现非特异性,C反应蛋白检查对早期诊断有一定价值;此类败血症易并发化脓性脑膜炎。头孢菌素类抗生素耐药性上升显著。
Objective To investigate the clinical features and drug resistance changes of Escherichia coli in neonatal sepsis in recent years and provide the basis for early diagnosis and reasonable treatment. Methods From January 2002 to October 2008 in our hospital, 40 cases of neonatal Escherichia coli septicemia confirmed clinical data and susceptibility results were retrospectively analyzed. Results The clinical manifestations of neonatal Escherichia coli septicemia varied, with fever, jaundice and other more common, 75.7% of cases of abnormal C-reactive protein. In 40 cases of neonatal Escherichia coli septicemia in 12 cases of purulent meningitis. Escherichia coli amikacin, ciprofloxacin, cefoxitin resistance rate is low, no resistance to imipenem, the commonly used cephalosporin resistance and the production of extended-spectrum β-lactam Enzyme rate in recent years increased significantly. At the same time due to Escherichia coli late hair sepsis earlier hair type resistance rate is high. Conclusion Neonatal Escherichia coli septicemia clinical manifestations of non-specific, C-reactive protein test has some value in the early diagnosis; such sepsis is complicated by purulent meningitis. Cephalosporin antibiotic resistance increased significantly.