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目的:探讨新生儿社区感染性肺炎(CAP)的病原菌分布、细菌耐药性及用药情况。方法:对2011年1月至2012年10月收治的126例新生儿CAP患儿行痰标本病原菌检测和药敏分析。结果:126例痰培养中,共检出92株(73.0%)致病菌。革兰阳性菌41株(44.6%),其中金黄色葡萄球菌29株(70.7%)最多见;革兰阴性菌51株(55.4%),其中肺炎克雷伯菌26株(51%)最多见。不同性别和白细胞水平患儿感染的病原菌比较,差异有统计学意义(P<0.05)。经验性单一用药、联合用药对革兰阴性菌和革兰阳性菌的有效率分别为56.5%、74.1%和45.0%、55.0%,两者比较,差异均无统计学意义(P>0.05)。结论:对新生儿CAP患儿,应积极进行病原学检测和药敏试验以指导临床合理用药。
Objective: To investigate the distribution of pathogens, bacterial resistance and drug use in neonatal community-acquired pneumonia (CAP). Methods: From January 2011 to October 2012 in 126 cases of neonatal CAP admitted sputum specimens pathogen detection and drug susceptibility analysis. Results: Of the 126 sputum cultures, 92 (73.0%) pathogenic bacteria were detected. There were 41 Gram-positive bacteria (44.6%), of which 29 were Staphylococcus aureus (70.7%), 51 were Gram-negative bacteria (55.4%), of which 26 strains were Klebsiella pneumoniae (51%) . There were significant differences in pathogenic bacteria infection in children with different gender and leukocyte levels (P <0.05). The effective rate of combination of single-agent and combination-drug combination were 56.5%, 74.1% and 45.0%, 55.0% for Gram-negative bacteria and Gram-positive bacteria respectively. There was no significant difference between them (P> 0.05). Conclusion: Neonatal CAP children should actively carry out pathogen detection and susceptibility testing to guide clinical rational use of drugs.