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目的探讨本院新生儿败血症病原菌的分布及耐药情况,指导临床合理使用抗生素,促进医院感染的有效防控。方法对2006年1月至2011年5月我院新生儿科收治的败血症患儿进行回顾性分析,按照发病时间分为早发型败血症及晚发型败血症,并根据发生感染的地点分为社区获得性感染及医院感染。结果研究期间共收治新生儿败血症121例。早发型败血症50例(41.3%),病原菌以革兰阴性杆菌为主,共40例(80%),其中含产超广谱β内酰胺酶(ESBLS)株5例(10%),革兰阳性凝固酶阴性葡萄球菌10例(20%)。晚发型败血症71例(58.6%),其中社区感染56例(78.9%),病原菌以革兰阳性球菌为主,共30例(42.2%),革兰阴性杆菌26例(36.6%);医院感染15例(21.1%),革兰阴性杆菌7例(9.9%),其中产ESBLs株4例(5.6%),革兰阳性凝固酶阴性葡萄球菌4例(5.6%),真菌4例(5.6%),均为白色念珠菌。结论早发型败血症及晚发型败血症、社区获得性败血症及医院感染败血症病原谱不同,均有多重耐药菌产生。
Objective To investigate the distribution and drug resistance of neonatal sepsis in our hospital and to guide the rational use of antibiotics in clinical practice and to promote the effective prevention and control of nosocomial infections. Methods A retrospective analysis of children with septicemia admitted to our department from January 2006 to May 2011 was made into early-onset septicemia and late-onset septicemia according to the time of onset and divided into community-acquired infections according to the place of infection And hospital infection. Results A total of 121 neonates with septicemia were treated during the study period. Early onset sepsis 50 cases (41.3%), the main pathogenic bacteria Gram-negative bacilli, a total of 40 cases (80%), including ESBLs producing strains in 5 cases (10%), Positive coagulase-negative staphylococci in 10 cases (20%). There were 71 (58.6%) cases of late-onset septicemia, of which 56 (78.9%) were community-based infections. The main pathogenic bacteria were gram-positive cocci, with a total of 30 (42.2%) and Gram-negative bacilli (26.6% Gram-positive coagulase-negative staphylococci were found in 4 cases (5.6%), fungi in 4 cases (5.6%), Gram-positive coagulase negative staphylococci in 4 cases (5.6% ), Are Candida albicans. Conclusion Early onset septicemia and late-onset sepsis, community-acquired septicemia and nosocomial sepsis pathogenic spectrum are different, have multiple drug-resistant bacteria.