【摘要】 目的了解湖北地区新生儿败血症的细菌分布和耐药率,为临床合理用药提供依据。方法对湖北省16所医院2000~2004年的新生儿血培养阳性数据资料进行分析。结果1 019株细菌中,革兰阳性菌948株(93%),革兰阴性菌71株(7%),主要的分离菌为凝固酶阴性葡萄球菌(CNS)(79.8%),其次是肠球菌属(7.0%)、金黄色葡萄球菌(SAU)(4.5%)、克雷伯菌属(1.7%)和嗜麦芽寡养单胞菌(1.2%);19.6%的SAU和71.3%的CNS为耐甲氧西林葡萄球菌(MRSA),肠球菌属46.5%耐氨苄西林,除1株鹑鸡肠球菌外,均对万古霉素敏感;56%大肠埃希菌和35%肺炎克雷伯菌ESBLs阳性;革兰阴性杆菌对亚胺培南、阿米卡星和氟喹诺酮类抗菌药物耐药率较低在0~15.6%之间,对头孢一~四代抗菌药物的耐药率在20%~70%之间。结论新生儿败血症的主要病原菌为革兰阳性球菌,根据药敏结果合理使用抗菌药物降低病死率,采取一切措施降低医院感染的发生更为重要。更多还原

【Abstract】 OBJECTIVE To investigate the distribution and resistance rate of clinical isolates from neonatal sepsis in Hubei hospitals.METHODS The antimicrobial susceptibility of clinical isolates from(neonates) blood culture derived from sixteen hospitals in Hubei from 2000 to 2004,was retrospectively analyzed and tested by KirbyBauer(method).RESULTS A total of 1 019 strains were isolated from blood specimens,Gram-positive and Gram(-negative)(bacteria) accounted for 93% and 7% of these isolates,respectively.The main isolates were coagulase(-negative) staphylococci(CNS,79.8%),Enterococcus spp(7.0%),Staphylococcus aureus(SAU4.5%),Klebsiella spp(1.7%),Stenotrophomonas maltophilia(1.2%),and Escherichia coli(0.9%).71.3% CNS and 19.6% SAU were meticillin resistant,46.5% enterococci resistant to ampicillin and almost strains were susceptible to(vancomycin)(except E.gallinarum).ESBLs were detected in isolates of 56% E.coli and 35% K.pneumoniae.S.maltophilia was susceptible to trimethoprim(-sulfamethoxazole) and levofloxacin with resistance rate of 8.3% and 0%.In strains of other Gram-negative rods,resistance rate to imipenem,amikacin and fluoroquinolones were detected between 0% to 15%,and to cephalosporins Ⅰ-Ⅳ were between 20% to 70%.CONCLUSIONS Gram-positive cocci are important pathogens in neonatal sepsis,antimicrobials should be used on the result of(antimicrobial) susceptibility test.It is more important to reduce health care-associated(nosocomial) infections.更多还原