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目的 了解目前哈尔滨地区新生儿败血症病原菌的分布及药物敏感性现状 ,以制定相应对策 ,合理选择抗生素。方法 对 1999年 2月至 2 0 0 1年 12月住院的 2 35例新生儿败血症的临床资料进行回顾性分析。结果 2 35例共分离出病原菌 2 76株 ,以葡萄球菌居多 (2 0 8/ 2 76 ,75 4% ) ,其中金黄色葡萄球菌 19株 ,表皮葡萄球菌46株 ;微球菌属和肠球菌属各 10株 ,链球菌属 8株 ;其它革兰阳性球菌 6株 ;革兰阴性杆菌 2 0株 ;芽孢杆菌属 11株 ;棒状杆菌属 3株。并分离出 1株耐万古霉素的表皮葡菌球菌。葡萄球菌对青霉素、红霉素、苯唑青霉素的耐药率均在 80 %或更高 ,敏感药物主要有万古霉素、头孢哌酮、头孢唑林和头孢呋肟。革兰阴性杆菌对氨苄青霉素的总耐药率 >80 % ,敏感药物主要为第三代头孢类及氨基糖苷类药物。 2 35例中治愈 136例 ,好转 73例 ,放弃治疗 18例 (多伴有颅脑损伤 ) ,死亡 8例 (3 4% )。结论 凝固酶阴性葡萄球菌感染为本地区新生儿败血症的主要致病菌。表皮葡萄球菌对青霉素、红霉素、苯唑青霉素的耐药率最高 ,达 90 %以上。多重耐药葡萄球菌占检出葡萄球菌的 2 8%。革兰阴性杆菌感染减少。
Objective To understand the distribution and drug susceptibility status of neonatal sepsis in Harbin at present, in order to formulate corresponding countermeasures and select antibiotics reasonably. Methods The clinical data of 235 neonates with sepsis admitted to hospital from February 1999 to December 2001 were analyzed retrospectively. Results A total of 2 76 pathogenic bacteria were isolated from 2 35 patients, most of them were staphylococci (19.8%). Staphylococcus aureus (19), Staphylococcus epidermidis (46), Micrococcus and Enterococcus 10 strains each, Streptococcus 8 strains; 6 other Gram-positive cocci; 20 Gram-negative bacteria; Bacillus 11; Corynebacterium 3 strains. A strain of vancomycin-resistant Staphylococcus epidermidis was isolated. Staphylococcus aureus, penicillin, erythromycin, oxacillin resistance rates were 80% or more, sensitive drugs are mainly vancomycin, cefoperazone, cefazolin and cefuroxime. Gram-negative bacilli to ampicillin total resistance rate of> 80%, the main sensitive drugs for the third generation of cephalosporins and aminoglycosides drugs. Of the 35 cases, 136 cases were cured, 73 cases improved, 18 cases were given up for treatment (multiple traumatic brain injury) and 8 cases died (34%). Conclusion Coagulase-negative staphylococcal infection is the main pathogen of neonatal sepsis in this area. Staphylococcus epidermidis resistant to penicillin, erythromycin, oxacillin the highest, up to 90%. Staphylococcus aureus accounted for 28% of Staphylococcus aureus. Gram-negative bacilli infections decreased.