【摘要】 目的 调查分析安徽省儿童医院败血症新生儿血标本中病原菌分布及耐药性，为临床合理使用抗菌药物提供指导。方法 回顾性调取2019年1月至2022年12月安徽省儿童医院新生儿科诊断为败血症且血培养结果呈阳性的193例患儿的资料，采集患儿血标本后使用全自动血液细菌培养仪进行培养，使用微生物自动鉴定系统鉴定致病菌的类别，药敏试验通过最低抑菌浓度(MIC)法检测，了解患儿病原菌分布情况及对常用抗菌药物的耐药性。结果 193例患儿血标本共分离出革兰阴性菌57株(29.53%),构成比排在首位的病原菌为大肠埃希菌，其中超广谱β-内酰胺酶(ESBL)(-)的大肠埃希菌17株，ESBL(+)16株；革兰阳性菌122株(63.21%),构成比排在首位的病原菌为表皮葡萄球菌，第2～4位分别为溶血性葡萄球菌，人葡萄球菌亚种及金黄色葡萄球菌；真菌14株(7.25%)。ESBL(-)的大肠埃希菌对头孢他啶、亚胺培南无耐药性，对头孢呋辛、头孢噻肟、氨曲南、阿米卡星的耐药率均<20%;ESBL(+)的大肠埃希菌对亚胺培南无耐药性，对除亚胺培南、阿米卡星以外的其他抗菌药物的耐药率均>50%。主要革兰阳性菌对氨苄西林、青霉素、红霉素的耐药率均>50%,对利福平耐药率均<10%,对万古霉素均无耐药性。结论 败血症新生儿感染的病原菌主要为表皮葡萄球菌、大肠埃希菌、溶血性葡萄球菌，对常用抗菌药物如氨苄西林、青霉素的耐药性较高。应结合患儿病原菌耐药情况选择敏感性高的药物对其进行治疗，以减少耐药菌株出现。更多还原

【Abstract】 Objective To investigate and analyze the distribution and drug resistance of pathogenic bacteria in blood samples of newborns with sepsis in Anhui Children’s Hospital, in order to provide guidance for the rational use of antibiotics in clinical. Methods The data of 193 children diagnosed with sepsis and positive blood culture results in the neonatology Department of Anhui Children’s Hospital from January 2019 to December 2022 were retrospectively collected. Blood samples of the children were collected and cultured using a fully automated blood bacterial culture instrument, automatic microbial identification system was applied to identify the categories of pathogenic bacteria, the drug sensitivity test was conducted using the minimum inhibitory concentration(MIC) method, the distribution of pathogenic bacteria in children and their resistance to commonly used antibiotics were understood. Results A total of 57 strains(29.53%) of Gram negative bacteria were isolated from blood samples of 193 pediatric patients, the pathogen with the highest composition ratio was Escherichia coli,among them, 17 strains of E. coli with extended spectrum β-lactamase(ESBL)(-) and 16 strains of ESBL(+);122 strains(63.21%) were Gram positive bacteria, with Staphylococcus epidermidis ranking first in terms of composition, hemolytic Staphylococcus,human Staphylococcus subspecies,and Staphylococcus aureus ranking second to fourth respectively; 14 strains of fungi(7.25%). Escherichia coli with ESBL(-) showed no resistance to ceftazidime or imipenem, while the resistance rates to cefuroxime, cefotaxime, aztreonam, and amikacin were all less than 20%;E. coli with ESBL(+) showed no resistance to imipenem, and the resistance rates to other antibiotics except imipenem and amikacin were >50%. The resistance rates of the main gram-positive bacteria to ampicillin, penicillin, and erythromycin were all over 50%,while the resistance rates to rifampicin were all less than 10%,and there was no resistance to vancomycin. Conclusion The main pathogens of infection in newborns with sepsis are Staphylococcus epidermidis,E. coli,and S. hemolytic,with high resistance to commonly used antibiotics such as ampicillin and penicillin.High sensitivity drugs should be selected for treatment based on the resistance of pathogenic bacteria in children, in order to reduce the emergence of drug-resistant strains.更多还原