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目的探讨新生儿重症监护病房(NICU)洋葱伯克霍尔德氏菌(BC)感染的临床特点。方法对2006年1月至2013年12月NICU收治的BC感染患儿进行回顾性分析,总结临床特征、细菌耐药性及治疗情况。结果 8年BC感染16例,发生率0.54‰。诊断为新生儿肺炎13例、新生儿败血症3例。临床主要表现为气促14例、青紫10例、呻吟4例;常见并发症有呼吸衰竭10例、心力衰竭9例、肺动脉高压5例、多器官功能损害3例;5例(5/16)考虑为医院感染,气管插管机械通气患儿医院感染发生率(2.44‰)高于鼻塞无创辅助通气患儿(0.25‰)。BC对头孢吡肟、头孢他啶、哌拉西林/他唑巴坦、美罗培南、头孢哌酮/舒巴坦耐药率均<30%。结论 BC是新生儿感染较少见的病原菌,主要表现为新生儿肺炎和败血症,对多种抗生素耐药率高,气管插管机械通气的患儿,医院感染BC的发生率较高。
Objective To investigate the clinical features of Burkholderia cepacia (BC) infection in neonatal intensive care unit (NICU). Methods A retrospective analysis was performed on children with BC infection admitted to NICU from January 2006 to December 2013, and clinical features, bacterial resistance and treatment were summarized. Results 8 cases of BC infection in 16 cases, the incidence of 0.54 ‰. Diagnosis of 13 cases of neonatal pneumonia, neonatal sepsis in 3 cases. Clinical manifestations were 14 cases of shortness of breath, bruising purple in 10 cases, moaning in 4 cases; common complications were respiratory failure in 10 cases, 9 cases of heart failure, pulmonary hypertension in 5 cases, multiple organ damage in 3 cases; 5 cases (5/16) Considering hospital infection, the incidence of nosocomial infection in children with mechanical ventilation (2.44 ‰) was higher than that of noninvasive assisted ventilation (0.25 ‰) in patients with endotracheal intubation. BC to cefepime, ceftazidime, piperacillin / tazobactam, meropenem, cefoperazone / sulbactam resistance rates were <30%. Conclusion BC is a rare pathogen of neonatal infection. It is mainly characterized by neonatal pneumonia and septicemia, high resistance rate to multiple antibiotics and high incidence of nosocomial infection in children with mechanical ventilation of tracheal intubation.