论文部分内容阅读
目的通过新生儿重症监护病房(NICU)医院感染阳性标本回顾性分析,了解病原菌分布及耐药性。方法收集2011—2015年医院感染病原菌阳性病例病原菌种类及耐药性资料,总结细菌分布及耐药情况。结果 255例中培养阳性151例,其中革兰氏阴性菌73.5%,真菌14.6%,革兰氏阳性菌11.9%。检出率前5位依次为:肺炎克雷伯菌、近平滑假丝酵母菌、白色念珠菌、产气肠杆菌和铜绿假单胞菌;革兰氏阴性菌多为产超广谱β-内酰胺酶菌(ESBLs),肠杆菌属对哌拉西林他唑巴坦、美罗培南耐药率多<30%,非发酵革兰氏阴性菌对哌拉西林他唑巴坦、头孢他啶、头孢哌酮舒巴坦耐药率均<30%,嗜麦芽窄食单胞菌对美罗培南耐药率100.0%;革兰氏阳性球菌多对甲氧西林耐药,未检出万古霉素耐药株;真菌对新生儿常用抗真菌药氟康唑、二性霉素B耐药率均较低。结论新生儿医院感染病原菌以革兰氏阴性菌为主,真菌检出率略高于革兰氏阳性菌,病原菌多为多重耐药菌,真菌耐药率较低。
Objective To retrospectively analyze the distribution of nosocomial infections and drug resistance in NICU hospitalized nosocomial infection specimens. Methods The types of pathogens and drug resistance data of positive cases of nosocomial infections from 2011 to 2015 were collected, and the distribution of bacteria and drug resistance were summarized. Results A total of 151 positive cases were cultured in 255 cases, of which 73.5% were Gram-negative bacteria, 14.6% were fungi and 11.9% were Gram-positive bacteria. The detection rate of the top five were: Klebsiella pneumoniae, Candida parapsilosis, Candida albicans, Enterobacter aerogenes and Pseudomonas aeruginosa; Gram-negative bacteria for the production of extended-spectrum β- Lactamases (ESBLs) and Enterobacter were more than 30% for piperacillin / tazobactam and meropenem, and non-fermentative Gram-negative bacteria were resistant to piperacillin / tazobactam, ceftazidime, cefoperazone The rates of ketosis sulbactam were all less than 30%, the rates of resistance to meropenem were 100.0% for Stenotrophomonas maltophilia, multi-methicillin-resistant Gram-positive cocci, no vancomycin-resistant strains were detected Fungi commonly used in neonates antifungal fluconazole, amphotericin B resistance rates were lower. Conclusion The main pathogens of nosocomial infection are Gram-negative bacteria. The detection rate of fungi is slightly higher than that of Gram-positive bacteria. The pathogens are mostly multi-resistant bacteria, and the fungal resistance rate is low.