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目的:分析新生儿败血症的临床表现,通过血培养检查及高敏C蛋白化验,研究新生儿使用抗生素的病原菌分布及耐药性,为今后降低和治疗新生儿败血症奠定基础。方法:对药敏结果分析,坚定病原菌,并化验患儿的高敏C反应蛋白。结果:在86例患儿血培养标本中分离出84株病原菌,其中有68例G+菌,排在前三位的是,金黄色葡萄球菌,表皮葡萄球菌,肠球菌,构成比例分别为57%、13%和4.7%。细菌产生耐药性的抗生素为红霉素、青霉素,细菌敏感的抗生素为替考拉宁和万古霉素;84株病原菌中G-菌为16例,排在前两位的是大肠埃希氏菌和不动杆菌,构成比例分别为9.4%、4.7%。所有抗生素中,环丙沙星、阿米卡星及哌拉西林效果比较好。经过化验,所有患儿的高敏C反应蛋白都具有明显的升高趋势,经过治疗后均显著下降。结论:条件致病菌明显增多,特别是凝固酶阴性葡萄球菌成为新生儿败血症主要致病因。哌拉西林、头抱哌酮舒巴坦、环丙沙星对G+、G-菌均敏感,可作为首选。对患有败血症的新生儿要合理使用抗生素,能有效的降低患儿的死亡率。
OBJECTIVE: To analyze the clinical manifestations of neonatal sepsis and to study the distribution and drug resistance of pathogens in newborn infants through blood culture examination and high-sensitivity protein C assay, so as to lay the foundation for the future reduction and treatment of neonatal sepsis. Methods: Analysis of drug susceptibility results, firm pathogenic bacteria, and laboratory tests of children with high-sensitivity C-reactive protein. Results: 84 strains of pathogens were isolated from blood samples of 86 children, of which 68 cases were G + bacteria. Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecium were the top three, accounting for 57% , 13% and 4.7% respectively. The bacteria producing antibiotic resistance were erythromycin, penicillin, bacterium-sensitive antibiotics, teicoplanin and vancomycin. Of the 84 pathogenic bacteria, 16 were G-bacteria, and the top two were Escherichia coli Bacteria and Acinetobacter, constitute the proportion of 9.4%, 4.7%. Among all antibiotics, ciprofloxacin, amikacin and piperacillin were better. After testing, all children with high-sensitivity C-reactive protein have a clear upward trend, after treatment were significantly decreased. Conclusion: The number of opportunistic pathogens increased significantly, especially coagulase-negative staphylococci became the main cause of neonatal sepsis. Piperacillin, the first closed pipeperidone sulbactam, ciprofloxacin G +, G-bacteria are sensitive, can be used as the first choice. The rational use of antibiotics in neonates with sepsis can effectively reduce the mortality rate in children.