新生儿血液培养细菌分布与耐药性变迁分析

目的探讨新生儿血液标本中细菌分布及其耐药性变化规律。方法回顾性分析2004～2007年新生儿感染患者血液培养细菌种类以及药物敏感试验结果,药物敏感试验方法为K-B法,根据CLSI标准判断药物敏感试验结果。结果2004～2007年期间,各年份新生儿血培养阳性率分别为6.7%、7.3%、6.9%以及7.4%,差异无统计学意义;1～7日龄组、8～14日龄组以及15～28日龄组新生儿血培养阳性率分别为9.1%、6.2%和5.9%,后两组新生儿血培养阳性率均显著低于1～7日龄组新生儿。2004～2007年期间,新生儿血培养阳性标本中位居前三位的细菌分别是葡萄球菌、假单胞菌以及肠道杆菌,优势菌种是表皮葡萄球菌和大肠埃希氏菌;表皮葡萄球菌对苯唑青霉素的耐药率逐年上升（42.1%～86.7%）,对第三代头孢菌素的耐药率较高并逐年上升;大肠埃希氏菌对第三代头孢菌素的耐药率低于表皮葡萄球菌对同类抗菌素的耐药率;表皮葡萄球菌和大肠挨希氏菌对环丙沙星的耐药率均较低。结论新生儿感染患者血液标本中细菌种类及其耐药性产生了变迁。

Strain distribution and antimicrobial resistance change analysis of bacteria isolated from blood specimens of neonate infection patients

Objective： To investigate the distribution and antimicrobial resistance change of bacteria isolated from blood specimens of neonate infection patients from 2004 to 2007. Methods ： The data of strain distribution and antimicrobial resistance of bacteria isolated from blood specimens of neonate infection patients from 2004 to 2007 were analyzed retrospectively. All of the bacteria isolates were tested by Kirby - Bauer susceptibility, and the antibiotic resistance was judged according to CLSI standard. Results ： From 2004 to 2007, the positive rate of neonate blood cluture in each year were 6. 7%, 7. 3%, 6. 9% and 7.4%, respectively, no statistically difference. The positive rate of blood cluture from 1 to 7 days, 8 to 14 days and 15 to 28 days neonate were 9. 1%, 6. 2% and 5.9%, respectively, and the positive rate of the latter two groups neonate were significantly lower than that of 1 to 7 days neonate group （ P 〈 0. 05）. For bacteria strain isolated from blood specimens of neonate infection patients, staphylococci, pseudomonas and bacterium entericum ranked in top three, in which staphylococcus epidermidis and escherichia eoli were prevalent strains. The percentage of staphylococcus epidermidis resistant to oxacillin raised every year from 42. 1% to 86. 7%, and the percentage of staphylococcus epidermidis resistant to third generation cephalosporin also raised every year. The percentage of escherichia coli resistant to third generation cephalosporin was lower than that of staphylococcus epidermidis. The percentage of staphylococcus epidermidis or escherichia coli resistant to ciprofloxacin was lower. Conclusion ： The strain type and antimicrobial resistance of bacteria isolated from blood specimens of neonate infection patients have changed.