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目的探讨新生儿医院获得性肺炎(HAP)的细菌种类、药敏情况及易感因素,指导临床用药。方法回顾性分析2006年1月至2009年7月本院新生儿病房住院的HAP患儿,总结其临床特点、细菌培养及药敏试验结果。结果 94例HAP标本均行痰培养检查,56例阳性,阳性率71.8%,共检出病原菌66株,84.8%为革兰阴性杆菌,以肺炎克雷伯菌为主,其次为不动杆菌和嗜麦芽窄食单胞菌。革兰阳性菌占15.2%,主要为葡萄球菌及链球菌。大多数革兰阴性杆菌对氨苄青霉素、第一二代头孢及多数三代头孢菌素耐药,对亚胺培能、头孢哌酮/舒巴坦敏感。革兰阳性球菌对青霉素、红霉素耐药率高,对万古霉素较敏感。结论新生儿HAP病原以革兰阴性菌为主,对大部分抗生素耐药,应积极防治。
Objective To investigate the bacterial species, drug susceptibility and susceptibility to neonatal hospital-acquired pneumonia (HAP) and to guide clinical medication. Methods A retrospective analysis of HAP children hospitalized in neonatal wards of our hospital from January 2006 to July 2009 was conducted. The clinical features, bacterial culture and drug sensitivity test results were summarized. Results 94 cases of HAP specimens were sputum culture examination, 56 cases were positive, the positive rate was 71.8%, a total of 66 strains of pathogens were detected, 84.8% were gram-negative bacilli, Klebsiella pneumoniae, followed by Acinetobacter and Stenotrophomonas maltophilia. Gram-positive bacteria accounted for 15.2%, mainly Staphylococcus aureus and Streptococcus. Most Gram-negative bacilli are resistant to ampicillin, first-second generation cephalosporins and most third-generation cephalosporins, and are sensitive to imipenem and cefoperazone / sulbactam. Gram-positive cocci penicillin, erythromycin high rate of resistance, more sensitive to vancomycin. Conclusions Newborn HAP pathogens are gram-negative bacteria, resistant to most antibiotics, and should be actively controlled.