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目的了解新生儿耳道分泌物病原菌的分布及耐药性,为临床诊治新生儿早发型感染及合理使用抗菌药物提供依据。方法对九龙坡区人民医院西城院区分娩的新生儿130例耳道分泌物进行病原菌的培养、分离、分析,并进行抗菌药物药敏试验检测和临床相关资料的分析。结果共分离出132株病原菌,前5位依次为大肠埃希菌、厌氧菌、粪肠球菌、无乳链球菌和白色假丝酵母菌。其中产ESBL的大肠埃希菌检出率为76.6%,大肠埃希菌对青霉素类抗菌药物、一代头孢具有较高的耐药率,对三代头孢耐药率较低,粪肠球菌和无乳链球菌对新生儿常用的青霉素类抗菌药物均保持较高的敏感性,白色假丝酵母菌对常见的抗真菌药物保持100%的敏感性。结论新生儿耳道分泌物中病原菌的分布及药敏试验对指导临床用药具有重要意义,可根据药敏试验结果合理使用抗菌药物。
Objective To understand the distribution and drug resistance of pathogenic bacteria in neonatal ear canal secretions and provide basis for clinical diagnosis and treatment of early-onset neonatal infection and rational use of antimicrobial agents. Methods 130 cases of newborn infants born in Xicheng District of Jiulongpo District People’s Hospital were cultured, isolated and analyzed for pathogenic bacteria, and antibacterial drug susceptibility tests and clinical data were analyzed. Results A total of 132 pathogenic bacteria were isolated. The top five were Escherichia coli, anaerobic bacteria, Enterococcus faecalis, Streptococcus agalactiae and Candida albicans. The detection rate of ESBL-producing Escherichia coli was 76.6%. Escherichia coli had a high resistance rate to penicillin-type antibiotics and cephalosporin first-generation, lower rates of third-generation cephalosporins, Enterococcus faecalis and no milk Streptococcus commonly used penicillin antibiotics in newborns are to maintain a high sensitivity, Candida albicans on the common anti-fungal drug to maintain 100% sensitivity. Conclusion The distribution of pathogenic bacteria in newborn’s ear canal secretions and drug susceptibility testing are of great importance to guide the clinical use of drugs, and the rational use of antibacterials can be based on the results of drug susceptibility testing.