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目的:调查新生儿重症监护病房(NICU)中早产儿铜绿假单胞菌感染的临床特点及耐药性,为其防治提供依据。方法:回顾性分析2011年9月~2013年8月广东省妇幼保健院NICU送检标本中铜绿假单胞菌培养阳性的早产患儿的临床资料。结果:早产儿铜绿假单胞菌感染的主要临床表现为呼吸困难、反应差、皮肤苍白、经皮血氧饱和度下降、气促、血糖不稳定、腹胀和发热等。实验室检查提示白细胞、CRP升高,血小板降低为较敏感的指标。铜绿假单胞菌对头孢唑啉、头孢呋辛、氨苄西林和氨苄西林/舒巴坦100%耐药,对哌拉西林、哌拉西林/舒巴坦、头孢他啶和头孢吡肟的敏感性较高。经合理治疗,53例铜绿假单胞菌感染患儿中治疗后好转或治愈出院48例,死亡5例。结论:早产儿铜绿假单胞菌感染临床表现多样,对存在严重基础疾病,机械辅助通气及住院时间长的患者应警惕铜绿假单胞菌感染,选用合适的抗菌药物治疗改善预后。
Objective: To investigate the clinical features and drug resistance of Pseudomonas aeruginosa infection in premature neonates in neonatal intensive care unit (NICU) and provide basis for its prevention and treatment. Methods: The clinical data of preterm infants with positive Pseudomonas aeruginosa culture in NICU specimens of Guangdong Provincial MCH Hospital from September 2011 to August 2013 were retrospectively analyzed. Results: The main clinical manifestations of Pseudomonas aeruginosa infection in preterm infants were dyspnea, poor response, pale skin, decreased percutaneous oxygen saturation, shortness of breath, unstable blood glucose, bloating and fever. Laboratory tests suggest that white blood cells, CRP increased, platelet reduction is more sensitive indicators. Pseudomonas aeruginosa to cefazolin, cefuroxime, ampicillin and ampicillin / sulbactam 100% resistance to piperacillin, piperacillin / sulbactam, ceftazidime and cefepime sensitivity high. After reasonable treatment, 53 patients with Pseudomonas aeruginosa infection improved or cured after treatment in 48 patients discharged, 5 patients died. Conclusion: The clinical manifestations of Pseudomonas aeruginosa infection in premature infants are diverse. Patients with Pseudomonas aeruginosa infection should be alert to patients with severe underlying diseases, mechanical ventilation and long hospital stay. Prognosis should be improved by appropriate antimicrobial agents.