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目的:了解最近5年我院新生儿重症监护室产ESBLs菌对常用抗生素的耐药情况。方法:采用琼脂扩散法检测22株产ESBLs菌对18种抗生素的敏感率。结果:医院感染好发部位为泌尿道、脐部、呼吸道和血液。从297例新生儿病例中分离出317株细菌,其中革兰氏阴性菌166株,包括大肠杆菌80株、假单胞菌23株、肺炎克雷伯氏杆菌20株;产ESBLs菌株共22株,占革兰氏阴性菌13.2%(22/166),其中,产ESBLs大肠埃希氏菌18株(尿7株,脐5株,血液3株,呼吸道2株,皮肤脓液1株),占全部大肠埃希氏菌22.5%,产ESBLs肺炎克雷伯氏菌4株(呼吸道、尿液、皮肤、脐部各1株),占全部肺炎克雷伯氏菌的20%。产ESBLs大肠埃希氏菌和产ESBLs肺炎克雷伯氏菌对氨苄青霉素、哌拉西林、庆大霉素、复方新诺明、头孢唑林、头孢呋辛、头孢噻肟、阿莫西林/克拉维酸、替卡西林/克拉维酸、头孢哌酮、头孢哌酮/舒巴坦、头孢曲松、头孢吡肟高度耐药;对丁胺卡那霉素、哌拉西林/他唑巴坦、头孢他啶、环丙沙星、亚胺培南敏感率仅20%~26%。结论:大肠杆菌是我院新生儿医院感染的主要病原菌之一,肺炎克雷伯氏菌和大肠埃希氏菌产ESBLs的情况已较为严重,产ESBLs菌显示出对多种抗生素的多重耐药性。
Objective: To understand the recent 5 years in our hospital neonatal intensive care unit ESBLs resistant strains of commonly used antibiotics. Methods: Agar diffusion method was used to detect the sensitivity of 22 ESBLs-producing strains to 18 antibiotics. Results: The nosocomial infection sites were urinary tract, navel, respiratory tract and blood. A total of 317 strains of bacteria were isolated from 297 neonates, of which 166 strains were Gram-negative bacteria, including 80 strains of Escherichia coli, 23 strains of Pseudomonas and 20 strains of Klebsiella pneumoniae. A total of 22 ESBLs-producing strains Accounting for 13.2% (22/166) of Gram-negative bacteria. Of these, 18 strains of ESBLs-producing Escherichia coli (7 strains of urine, 5 strains of navel, 3 strains of blood, 2 strains of respiratory tract, 1 strain of skin pus) Accounting for 22.5% of all Escherichia coli, ESBLs-producing Klebsiella pneumoniae 4 (respiratory, urinary, skin, umbilical 1 strain), accounting for 20% of all Klebsiella pneumoniae. Escherichia coli producing ESBLs and Klebsiella pneumoniae producing ESBLs against ampicillin, piperacillin, gentamicin, cotrimoxazole, cefazolin, cefuroxime, cefotaxime, amoxicillin / Clavulanic acid, ticarcillin / clavulanic acid, cefoperazone, cefoperazone / sulbactam, ceftriaxone, cefepime were highly resistant; for amikacin, piperacillin / tazobact Tanzania, ceftazidime, ciprofloxacin, imipenem sensitive rate of only 20% to 26%. Conclusion: Escherichia coli is one of the main pathogenic bacteria in nosocomial nosocomial infection in our hospital. Klebsiella pneumoniae and Escherichia coli producing ESBLs have become more serious. ESBLs-producing bacteria show multiple drug resistance to multiple antibiotics Sex.