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目的了解新生儿晚发型败血症(NLOS)病原菌分布及其耐药情况。方法根据血培养及药敏试验,回顾性分析2010年1月至2012年12月新生儿重症监护室(NICU)NLOS的病原菌分布及细菌耐药情况。结果该期间NICU共收治新生儿1 570例,诊断新生儿败血症73例(4.7%),其中NLOS 51例,占败血症患儿的69.9%。NLOS病原菌以肺炎克雷伯杆菌及凝固酶阴性葡萄球菌(CNS)为主。革兰阳性菌对青霉素、苯唑西林、头孢唑啉、红霉素耐药率普遍较高,但对万古霉素及利福平未发现耐药;革兰阴性菌对头孢唑啉、氨苄西林、第一、二代头孢菌素及不加酶的第三代头孢菌素耐药率较高,但对碳青霉烯类、头孢哌酮/舒巴坦及阿米卡星耐药率极低。结论肺炎克雷伯杆菌、CNS是本地区NLOS的主要病原菌,临床上应根据病原菌及药敏结果,选择敏感的抗菌药物。
Objective To understand the distribution and drug resistance of neonatal late-onset septicemia (NLOS). Methods According to blood culture and drug sensitivity test, the pathogen distribution and bacterial resistance of NLOS in neonatal intensive care unit (NICU) from January 2010 to December 2012 were retrospectively analyzed. Results During this period, NICU treated 1 570 neonates and diagnosed 73 cases of neonatal sepsis (4.7%), of which 51 were NLOS, accounting for 69.9% of children with sepsis. The pathogens of NLOS were Klebsiella pneumoniae and coagulase-negative staphylococcus (CNS). Gram-positive bacteria were generally resistant to penicillin, oxacillin, cefazolin, erythromycin, but no resistance to vancomycin and rifampicin. Gram-negative bacteria were resistant to cefazolin and ampicillin , The first and second generation cephalosporins and the third generation cephalosporins without enzyme resistance rate is higher, but the carbapenems, cefoperazone / sulbactam and amikacin resistance rate pole low. Conclusion Klebsiella pneumoniae and CNS are the main pathogens of NLOS in this region. According to the results of pathogen and drug susceptibility, CNS should be selected as sensitive antimicrobial agents.