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目的研究医院新生儿败血症病原菌的分布及耐药性,指导临床合理使用抗菌药物。方法采用病例对照研究的方法,对医院2006年1月-2011年5月新生儿重症监护病房121例败血症确诊患儿进行回顾性分析,按发病时间分为早发型及晚发型败血症,并根据发生感染的地点分为社区获得性感染及医院感染。结果新生儿败血症病原菌以革兰阴性菌为主,73株占60.33%,革兰阳性菌44株占36.36%,真菌4株占3.31%,早发型与晚发型败血症中大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、阴沟肠杆菌、金黄色葡萄球菌、白色假丝酵母菌、链球菌属与败血症比较,差异有统计学意义(P<0.05),社区与医院感染败血症中大肠埃希菌、肺炎克雷伯菌、嗜麦芽寡养单胞菌、金黄色葡萄球菌、白色假丝酵母菌比较,差异有统计学意义(P<0.05),产ESBLs大肠埃希菌、肺炎克雷伯菌检出率分别为15.79%、16.67%;革兰阴性菌、革兰阳性菌对青霉素、氨苄西林均耐药。结论早发型及晚发性败血症、社区获得性及医院感染败血症病原谱不同,均有多药耐药菌产生。
Objective To study the distribution and drug resistance of neonatal sepsis in hospitals and to guide the rational use of antibiotics in clinical practice. Methods A case-control study was conducted in 121 children diagnosed with sepsis in neonatal intensive care unit from January 2006 to May 2011 in our hospital. According to the time of onset, the patients were divided into early-onset and late-onset sepsis. Infection is divided into community-acquired infections and nosocomial infections. Results The main pathogens of neonatal sepsis were Gram-negative bacteria, 73 strains accounted for 60.33%, 44 strains Gram-positive bacteria accounted for 36.36%, 4 fungi accounted for 3.31%, early-onset and late-onset sepsis Escherichia coli, Leptospira, Acinetobacter baumannii, Enterobacter cloacae, Staphylococcus aureus, Candida albicans, Streptococcus and septicemia, the difference was statistically significant (P <0.05), community and hospital infection in the large intestine Escherichia coli, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Staphylococcus aureus, Candida albicans, the difference was statistically significant (P <0.05), producing Escherichia coli ESBLs, g The detection rates of Leishmaniasis were 15.79% and 16.67% respectively. Gram-negative bacteria and Gram-positive bacteria were resistant to penicillin and ampicillin. Conclusion Early onset and late-onset sepsis, community-acquired and hospital-acquired sepsis pathogenic spectrum are different, have multi-drug resistant bacteria.