【摘要】 目的了解某院新生儿科多重耐药菌的菌种和耐药情况,指导新生儿科临床合理应用抗菌药物。方法对某院新生儿科2016—2018年发生的315例新生儿多重耐药菌感染的细菌监测结果进行分析。结果共检出多重耐药菌株351株,对3～10类抗菌药物耐药。革兰阴性菌273株,占77.8%,其中肺炎克雷伯菌179株排名第一,而产超广谱β内酰胺酶(ESBL)菌株为97株,占27.6%;肺炎克雷伯菌对头孢唑林、头孢呋辛、头孢曲松、头孢他啶耐药率较高,且呈逐年增加的趋势,对头孢噻肟、头孢吡肟的耐药率呈逐年下降趋势;大肠埃希菌对头孢唑林、头孢呋辛、头孢曲松、头孢噻肟、头孢吡肟的耐药率有所下降,但整体耐药率仍达50%以上。革兰阳性菌78株,占22.2%,其中以表皮葡萄球菌、溶血葡萄球菌、金黄色葡萄球菌位列前三。革兰阳性菌对氨苄西林/舒巴坦、阿莫西林/克拉维酸、青霉素、氨苄西林、苯唑西林、头孢曲松耐药均达100%,对万古霉素、利奈唑胺、莫西沙星、奎奴普丁/达福普丁、达托霉素均高度敏感。结论该院新生儿科多重耐药菌感染的病原菌主要以革兰阴性杆菌为主,且对大部分抗菌药物产生了耐药。更多还原

【Abstract】 Objective To understand the strains and drug resistance of multi-drug resistant strains in neonatology in our hospital,and to guide the rational application of antibiotics in neonatology.Methods A total of 315 neonatal bacterial surveillance results of multi-drug resistant infections from 2016 to 2018 in the neonatology department of our hospital were analyzed.Results A total of 351 multi-drug resistant strains and 273 Gram-negative bacteria were detected,accounting for77.8%.Among them,179 strains of Klebsiella pneumoniae ranked first,while strains producing extended-spectrum β-lactamase( ESBL) strain were 97 strains,accounting for 27.6%; Klebsiella pneumoniae resistance to cefazolin,cefuroxime,ceftriaxone,ceftazidime was higher,and was increasing year by year,the resistance rate to cefotaxime,cefepime.The trend of declining year by year; The resistance rate of Escherichia coli to cefazolin,cefuroxime,ceftriaxone,cefotaxime,cefepime decreased,but the overall resistance rate still reached more than 50%. There were 78 Gram-positive bacteria,accounting for22.2%.The top three were Staphylococcus epidermidis,Staphylococcus haemolyticus and Staphylococcus aureus.Gram-positive bacteria resistant to ampicillin/sulbactam,amoxicillin/clavulanic acid,penicillin,ampicillin,oxacillin,ceftriaxone 100%,to vancomycin,linezolid,moxifloxacin,quinupristin/dalfopristin,and daptomycin are highly sensitive.351 multi-drug resistant strains were resistant to 3 ～ 10 antibiotics.Conclusion The pathogens of multidrug-resistant bacteria in the neonatology department of our hospital are mainly Gram-negative bacteria,which are resistant to most antibiotics.更多还原