论文部分内容阅读
目的通过对新生儿重症监护病房(NICU)住院患儿多重耐药菌的定植状况以及耐药特点调查分析,为预防和控制多重耐药菌在院内的传播及临床合理用药提供科学依据。方法对2015年5月-2016年5月在医院NICU住院治疗的患儿进行细菌学监测,取198例患儿鼻咽拭子和直肠拭子进行筛查培养并做药敏试验,采用WHONET 5.6软件进行细菌耐药性分析。结果在26例患儿标本中检测到多重耐药菌,多重耐药菌定植率13.13%。监测目标菌中包括24株产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌和2株耐甲氧西林金黄色葡萄球菌(MRSA),未检测到多重耐药的鲍曼不动杆菌和铜绿假单胞菌。24株产ESBLs肠杆菌科细菌对氨苄西林、哌拉西林、头孢唑啉的耐药率极高为100.00%;21株肺炎克雷伯菌对亚胺培南及美罗培南的耐药率为42.86%;2株耐甲氧西林金黄色葡萄球菌对万古霉素、喹奴普汀、利奈唑胺敏感。结论该院NICU住院患儿多重耐药菌定植率较高,耐药现象严重。应引起临床医生的高度重视,加强监测,避免多重耐药菌在医院暴发流行。
OBJECTIVE: To investigate the colonization of multidrug-resistant bacteria in infants with neonatal intensive care unit (NICU) and the characteristics of multidrug-resistant bacteria in hospitalized patients, and to provide a scientific basis for the prevention and control of the spread of multidrug-resistant bacteria in the hospital and clinical rational drug use. Methods From May 2015 to May 2016, bacteriological monitoring was performed on children hospitalized in the NICU of the hospital. 198 nasopharyngeal swabs and rectal swabs were screened and drug susceptibility tests were carried out using WHONET 5.6 Software for bacterial resistance analysis. Results Multiple resistant strains were detected in 26 cases of children and the rate of multidrug resistant colonization was 13.13%. The surveillance target bacteria included 24 strains of enterobacteriaceae producing ESBLs and two strains of methicillin-resistant Staphylococcus aureus (MRSA), and no multi-drug resistant Acinetobacter baumannii And Pseudomonas aeruginosa. The resistance rates of 24 ESBLs-producing Enterobacteriaceae strains to ampicillin, piperacillin and cefazolin were 100.00%. The resistance rates of 21 strains of Klebsiella pneumoniae to imipenem and meropenem were 42.86 %. Two strains of methicillin-resistant Staphylococcus aureus were sensitive to vancomycin, quetiapine and linezolid. Conclusion The NICU hospitalization of children with multiple drug-resistant bacteria colonization rate is high, drug resistance is serious. Should be caused by clinicians attach great importance to strengthen monitoring to prevent multiple drug-resistant bacteria outbreaks in the hospital.