【摘要】 目的分析胎膜早破新生儿口腔分泌物细菌的分布特点、耐药情况以及不同分娩方式的细菌分离阳性率,为临床合理的预防性使用抗生素提供科学的指导。方法对2011年1月至2012年12月广东省妇幼保健院新生儿科送检的116份胎膜早破新生儿口腔分泌物标本进行细菌培养,并以法国梅里埃的全自动细菌鉴定药敏系统(VITEK-2 compact)对分离出的纯菌株进行鉴定和药敏试验,统计不同分娩方式的阳性率。结果 116份口腔分泌物标本中,共分离出细菌33株/31例,总检出率为26.7%,其中G-菌28株,占84.8%,G+菌5株,占15.2%,检出率最高的细菌是大肠埃希菌17株(51.5%),其除了对丁胺卡那霉素、头孢替坦和亚胺培南全部敏感以外,对其他的抗生素均有不同程度的耐药,两种分娩方式的细菌培养阳性率差异无统计学意义(P=0.491)。结论胎膜早破新生儿口腔分泌物培养以G-菌为主且耐药性较高,临床应根据药敏结果合理选用抗生素进行预防用药;在无医学指针的情况下,推荐阴道分娩。更多还原

【Abstract】 Objective To analyze the distribution and drug resistance of pathogenic bacteria in oral secretion samples from neonates with premature rupture of membranes and the impact of delivery mode in order to guide rational clinical use of antibiotics. Methods116 oral secretion samples of neonates with premature rupture of membranes from newborn department of our hospital from Jan. 2011 to Dec. 2012 were cultured; the isolated pure strains were identified and their drug-susceptibility were tested by VITEK-2 automicroscan;the positive rates of bacterial culture of different delivery modes were analyzed statistically. Results Among the 116 cases of oral secretion samples,33 strains of bacteria were isolated,which belonged to 31 cases,and the total detection rate was 26. 7%. The infections of G-bacteria accounted for 84. 8%,whereas G+bacteria 15. 2%. The highest isolating rate was of E. coli( 17 strains,51. 5%). The antibiotic sensiitivities of E. coli to Amikacin,Cefotetan and Imipenem were 100%,but those to other antibiotics were low. The difference in positive rates of bacterial culture between both delivery modes was not statistically significant( P = 0. 491). Conclusion Gram-negative bacilli are the main pathogens isolated in oral secretion samples of neonate with premature rupture of membranes and their drug resistance is high. It is important to consider preventive medication rationally according to drug sensitivity test; Vaginal delivery is suggested when there is no medical pointer.更多还原