Abstract:

Objective    To analyse the pathogen distribution and drug resistance status in 268 cases of neonatal sepsis. Methods    Totally 268 cases of neonatal sepsis were chosen who had been hospitalized between 2010 and 2015 with blood culture being positive. They were divided into early-onset and late-onset sepsis groups and their clinical characteristics，pathogen distribution and drug resistance were explored. Results    The gram-negative bacteria were the major pathogens early-onset sepsis group（58.3%），in which escherichia coli was 31.2% and klebsiella pneumoniae was 23.9%. Gram-positive bacteria were the major pathogen in late-onset sepsis group（65.1%），in which coagulase negative staphylococcus was 46.5% and excrement enterococcus was 11.6%. Gram-positive bacteria were sensitive to vancomycin with durg resistance rate ＞90% to penicillin，＞80% to erythromycin，＞60% to clindamycin，ampicillin and cefazolin . Gram-negative bacteria were sensitive to meropenem. Gram-negative bacteria showed high resistance to ampicillin，piperacillin and cefotaxime，but low resistance to ceftazidime and cefoperazone. Conclusion    The common pathogens and clinical characteristics are different in the early-onset and late-onset sepsis groups. It is important to choose reasonable antibiotic drugs and strengthen drug resistance surveillance.

Key words: septicemia, drug resistance, antibiotics, pathogenic bacterium, neonate

摘要：

目的    探讨新生儿败血症病原菌分布及耐药情况。方法    选取2010-2015年内蒙古通辽市医院收治的268例血培养阳性的败血症患儿，分为早发型和晚发型组，分析其临床特点、病原菌分布及耐药情况。结果    早发型败血症病原菌以革兰阴性菌为主（58.3％），其中大肠埃希菌（31.2%），肺炎克雷伯杆菌（23.9%）。晚发型败血症病原菌以革兰阳性菌为主（65.1%），其中包括凝固酶阴性葡萄球菌（46.5％）、屎肠球菌（11.6%）。革兰阳性菌对万古霉素敏感，对青霉素、红霉素耐药率＞80％，对克林霉素、氨苄西林、头孢唑啉的耐药率均＞60％。革兰阴性菌对美罗培南敏感，对头孢他啶、头孢哌酮耐药率较低，对氨苄西林、哌拉西林、头孢噻肟耐药率较高。结论    新生儿早发型及晚发型败血症的临床特点及常见病原菌不同，治疗时应合理应用抗生素类药物，加强耐药性监测。

关键词: 败血症, 耐药, 抗菌素, 病原菌, 新生儿