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目的研究观察新生儿肺炎克雷伯菌败血症的临床特点及药物敏感情况。方法回顾性分析本院2014年2月至2016年7月收治的肺炎克雷伯菌败血症新生患儿100例资料,观察患儿病症特点,并利用药物试验分析患儿对临床药物敏感状况。结果新生儿在发病后,其症状复杂且多样化,可导致多处器官组织受累,其中呼吸困难发生率63%(63/100),持续低热53%(53/100),黄疸28%(28/100),精神萎靡不振37%(37/100),呕吐腹泻29%(29/100),肝损害23%(23/100),皮疹12%(12/100),肾功能损害12%(12/100),惊厥5%(5/100),弥漫性血管内凝血11%(11/100);通过全面的药物检测,证实肺炎克雷伯菌败血症选择阿米卡星、亚胺培南药敏率最高,其次为环丙沙星、哌拉西林/他唑巴坦、庆大霉素等,对于头孢唑啉、头抱曲松、头抱西丁等药物敏感度极低。结论肺炎克雷伯菌败血症病情特点复杂,可危及多处组织器官,引起系统功能障碍,在临床用药方面需结合患儿药敏检测结果给予针对性抗生素用药,降低新生儿机体损伤。
Objective To study the clinical features and drug sensitivity of neonatal Klebsiella pneumoniae septicemia. Methods A retrospective analysis of 100 cases of neonates with Klebsiella pneumoniae septicemia admitted from February 2014 to July 2016 in our hospital was conducted to observe the characteristics of the disease in children and analyze the clinical drug sensitivity of children with drug test. Results After the onset of newborns, the symptoms were complicated and diversified, which resulted in the involvement of multiple organs and tissues. The incidence of dyspnea was 63% (63/100), 53% (53/100) sustained low fever and 28% (28%) of jaundice / 100), 37% (37/100) in vomiting, 29% (29/100) in vomiting diarrhea, 23% (23/100) in liver damage, 12% 12/100), convulsions 5% (5/100), disseminated intravascular coagulation 11% (11/100); through a comprehensive drug testing, confirmed klebsiella pneumoniae sepsis selection amikacin, imipenem The highest rate of drug sensitivity, followed by ciprofloxacin, piperacillin / tazobactam, gentamicin, cefazolin, the first embracing pineal, crab cystin and other drugs with very low sensitivity. Conclusions The characteristics of Klebsiella pneumoniae septicemia are complicated and can endanger the tissues and organs of many places and cause systemic dysfunction. In the aspect of clinical medication, antibiotic medication should be given in combination with the drug susceptibility test result of children to reduce the damage of neonatal body.