首页|RDS晚期早产儿呼吸机相关肺炎病原菌分析

RDS晚期早产儿呼吸机相关肺炎病原菌分析

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目的 探讨新生儿重症监护室(NICU)中呼吸窘迫综合征(RDS)晚期早产儿呼吸机相关肺炎(VAP)临床病原学特点及细菌耐药性,为抗生素选择提供依据.方法 收集2013年1月 2015年12月我院NICU收治的并发VAP的RDS晚期早产儿38例,所有病儿均行气管内分泌物培养和药物敏感试验.结果 38例行痰培养,30例细菌培养阳性,阳性率为78.95%.共培养出病原菌40株,其中革兰阳性菌3株(7.5%),革兰阴性菌37株(92.5%),肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌是3种主要致病菌.肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)菌株12株,占60%,且产ESBLs菌株较非产ESBLs菌株耐药性高.铜绿假单胞菌及鲍氏不动杆菌未检出产ESBLs菌株.3种主要致病菌均对头孢类抗生素有较高耐药性,对亚胺培南、哌拉西林他唑巴坦及环丙沙星敏感.结论 RDS晚期早产儿VAP的主要致病菌为革兰阴性菌,且对临床常用抗生素广泛耐药.
AN ANALYSIS OF PATHOGENIC BACTERIA OF VENTILATOR-ASSOCIATED PNEUMONIA IN LATE PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME
Objective To instigate the distribution and drug resistance of pathogenic bacteria of ventilator associated pneumonia (VAP) in late preterm infants with respiratory distress syndrome (RDS) in neonatal intensive care unit (NICU),and to provide a reference for antibiotic selection.Methods A retrospective analysis was performed in 38 late preterm infants with RDS who developed VAP during mechanical ventilation in the NICU of Qingdao Women and Children Hospital from January 2013 to De cember 2015.The tracheal secretion culture and drug sensitivity test were performed in all patients.Results Of all the 38 pa tients,30 (78.95%) had a positive bacterial culture.A total of 40 strains of pathogenic bacteria were isolated,including 3 Grampositive strains (7.5 %) and 37 Gram-negative strains (92.5 %).Klebsiella pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii were the three main pathogenic bacteria.There were 12 strains of extended-spectrum β lactamases (ESBLs)-producing Klebsiella pneumoniae (60%) and the ESBLs-producing strains had a higher drug resistance than the non-ESBLs producing strains.There were no ESBLs producing Pseudomonas aeruginosa and Acinetobacter baumannii.The three main pathogenic bacteria had a high resistance to cephalosporins and were sensitive to imipenem,piperacillin tazobactam,and ciprofloxacin.Conclusion Gram-negative bacteria are main pathogenic bacteria of VAP in late preterm infants with RDS and they are extensively resistant to common antibiotics.

infant,prematurerespiratory distress syndrome, newbornpneumonia, ventilator-associatednoxaemicrobial sensitivity tests

王焕焕、冯向春、单若冰

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青岛市妇女儿童医院 新生儿科,山东青岛 266034

青岛市妇女儿童医院 NICU,山东青岛 266034

婴儿,早产 呼吸窘迫综合征,新生儿 肺炎,呼吸机相关性 病原 微生物敏感性试验

2017

齐鲁医学杂志
青岛大学医学院

齐鲁医学杂志

影响因子:0.609
ISSN:1008-0341
年,卷(期):2017.32(2)
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