| 俞珍惜,芦惠.新生儿呼吸机相关性肺炎病原菌构成及药敏分析[J].浙江中西医结合杂志,2015,25(9): |
| 新生儿呼吸机相关性肺炎病原菌构成及药敏分析 |
| Pathogens and drug sensitivity for ventilator-associated pneumonia in neonates |
| 投稿时间：2015-01-27 修订日期：2015-01-27 |
| DOI： |
| 中文关键词: 呼吸机相关性肺炎 新生儿 病原菌 药敏试验 |
| 英文关键词:ventilator-associated pneumonia neonate pathogen drug sensitivity |
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| 中文摘要: |
| 目的：了解新生儿呼吸机相关性肺炎(ventilator-associated pneumonia, VAP)的病原菌构成及细菌药敏以指导临床合理应用抗菌药。方法：回顾性分析新生儿重症监护病房(neonatal intensive care unit, NICU)2011年1月~2013年12月期间发生VAP患儿的病原菌构成及药敏试验结果。结果：共发生VAP33例,发生率为28.2%。分离出细菌37株,其中革兰氏阴性杆菌30株(占81.1%),依次为阴沟肠杆菌、肺炎克雷伯菌、鲍曼不动杆菌、产气肠杆菌及铜绿假单胞菌,对环丙沙星、左氧氟沙星、阿米卡星、庆大霉素敏感性最高(85.7%~100.0%),对亚胺培南、哌拉西林/他唑巴坦、头孢吡肟、头孢哌酮/舒巴坦次之(57.1%~100.0%)。革兰氏阳性球菌7株(占18.9%),依次为草绿色链球菌、表皮葡萄球菌及溶血葡萄球菌,均对万古霉素敏感。结论：新生儿VAP病原菌以革兰氏阴性杆菌为主,阴沟肠杆菌占首位,临床医师应根据本地区VAP病原菌谱及药敏合理使用抗菌药。 |
| 英文摘要: |
| Objective To study the pathogens and drug sensitivity for ventilator-associated pneumonia (VAP) in neonates for providing guidance on the rational use of antibiotics. Methods The pathogens and drug sensitivity for 33 VAP in our hospital’s neonatal intensive care unit (NICU) from January 2011 to December 2013 were analyzed retrospectively. Results A total of 117 cases had mechanical ventilation (MV) lasting over 48 hours or more, of which 33 cases had VAP with the incidence of 28.2%. 37 strains of pathogens were isolated, Gram-negative bacilli was the main pathogens (30 strains, accounting for 81.1%), which were Enterobacter cloacae, Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter aerogenes and Pseudomonas aeruginosa, with highest sensitivity to ciprofloxacin, levofloxacin, amikacin and gentamicin (85.7%~100.0%), followed by imipenem, piperacillin-tazobactam, cefepime and cefoperazone sulbactam (57.1%~100.0%). 7 strains of Gram-positive cocci (accounting for 18.9%) were isolated, which were Viridans Streptococci, Staphylococcus epidermidis and Staphylococcus haemolyticus, all sensitive to vancomycin. Conclusions The pathogens for VAP in neonates are mainly Gram-negative bacilli, as Enterobacter cloacae at the first place. Clinicians should use antibiotics rationally based on the pathogens and drug sensitivity in the locality. |
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