摘要
Abstract
Objective To investigate the common bacterial pathogens and the change in their resistance to antibiotics in NICU, and provide guidance for the use of antibiotics. Methods From Jan. 2005 to Dec. 2007 in Xiamen First Hos-pital Affiliated to Fujian University of Medical Sciences , 554 bacterial culture positive cases were collected. Analyze the common pathogens and the change in their resistance. Results (1) Fifty-three species out of 595 pathogenic bacteria were detected, Klebsiella pneumonia was of the most common.(2)Eighty-one Klebsiella pneumonia producing extended spectrum β lactamases( ESBL) were detected in total, the detective rate among the three years showing a marked decline (P < 0.05) , whereas the detective rate of multiple drug resistant non-zymophyte and fungus showed a steady increase over the three years(P < 0.01 ).(3)Drug sensitivity assay revealed that the gram positive cocci possessed a higher degree of drug resistance to ampicillin, piperacillin, Cefazolin, sulbactam, and Cefuroxime with a percentage of 56.6%~ 92.2%, which was significantly higher than the resistance to Amikaxin, piperacillin/tazobactam, ciprofloxacin, imipen-em, and ceftazidime(P < 0.05). ESBL producing bacteria were totally resistant to ceftriaxone and cefotaxim, and the gram positive bacilli possessed a higher degree of drug resistance to penicillin, cephazoline, oxacillin and erythromycin (74.4%~83.4%) than to Vancomycin or Clindamycin (P < 0.05). Conclusion (1) Klebsiella pneumonia is a major bacterial pathogen in the NICU of our hospital, fortunately its infection rate shows a decline tendency over recent years, and such a decline in positive rate of ESBLs producing Klebsiella pneumonia is closely relevant to the application of the third generation cephalosporin. (2)Increasing infections due to multiple drug resistant non-zymophyte and mycocandida are gradually becoming 2nd or 3rd common pathogens, which requires certain attention. (3)The drug resistance problem in NICU causes serious concerns. Imipenem, piperacillin/ tazobactam and Vancomycin can be used in NICU as em-pirical drugs for the treatment of severe infection, while non-zymophyte infection should be cared about.关键词
新生儿/重症监护/细胞感染/耐药性Key words
neonate/ intensive care/ infection/ drug resistance分类
医药卫生
