新生儿细菌感染性肺炎的病原菌分布及耐药性分析*

夏晓文邵小燕李永红

(鄂州市妇幼保健院儿科， 湖北 鄂州 436000)

【摘要】目的探讨新生儿细菌感染性肺炎的病原菌分布特点与耐药性特征，为临床诊疗提供参考依据。方法对2541例新生儿肺炎患儿进行细菌培养与鉴定，并对主要细菌的药物敏感状况进行分析。结果2541例新生儿细菌感染性肺炎患儿的主要检出病原菌为革兰氏阴性菌1051株(69.97%)，其次为革兰氏阳性杆菌451株(30.03%)。在革兰氏阴性菌其中主要为肺炎克雷伯菌(20.04%)和大肠埃希菌(14.58%)，其对亚胺培南的敏感性均在90%以上；在革兰氏阳性菌中主要为金黄色葡萄球菌，而金黄色葡萄球菌对万古霉素100%敏感。 结论新生儿细菌感染性肺炎患儿的主要感染病原菌为革兰氏阴性菌，而不同致病菌属的耐药性存在差异，治疗中应按照致病菌的构成及其耐药谱，规范地使用抗菌药物。

【关键词】细菌感染性肺炎； 耐药性； 病毒病原特征； 新生儿

【中图分类号】R 720.597【文献标志码】A

基金项目：湖北省科技厅攻关项目(201303261310)

收稿日期：( 2014-10-08； 编辑： 母存培)

Analysis of neonatal bacterial pneumonia pathogen and drug resistanceXIA Xiaowen, SHAO Xiaoyan, LI Yonghong

(DepartmentofPediatrics,EzhouMaternalandChildHealth-CareHospital,Ezhou436000,Hubei)

Abstract【】ObjectiveTo investigate the hospital neonatal bacterial pneumonia infection pathogenic bacteria distribution and drug resistance characteristics of children and provide reference basis for clinical prevention and treatment. MethodsFrom January 2013 to January 2014, the neonatal bacterial culture and identification of pneumonia in children were analyzed. ResultsOf 2541 strains, 1051 strains were Gram-negative bacteria (69.91%) and 452 strains were Gram-positive bacilli (30.09%). The main pathogens of Gram-negative bacteria were Pneumonia klebsiella bacteria (30.00%) and E. coli (28.00%). 90% of them were sensitive to imipenem. The main pathogen of Gram-positive bacteria were Staphylococcus aureus. 100% of them were sensitive to vancomycin. ConclusionIt is necessary to use antimicrobial drugs normatively according to the composition of pathogenic bacteria and their drug resistance in the spectrum.

【Key words】Bacterial pneumonia; Drug resistance; Virus pathogenic characteristics; Newborn

由于新生儿的抵抗力较差，营养状况不佳，故新生儿细菌感染性肺炎的发生率一直居高不下，对患儿的生命健康与安全造成严重的威胁[1]。随着分子生物学和生物信息学技术的进步，近年来不断有新的病原微生物被发现，新生儿细菌感染性肺炎的致病菌和耐药谱正在扩大[2]，这对抗菌药物的正确使用提出了更高的要求。本研究通过对我院收治的细菌感染性肺炎患儿的病原菌与耐药性特征进行分析，旨在为本地区新生儿感染性肺炎的预防与临床诊断提供参考依据，现报告如下。……