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新生儿重症监护病房中的细菌分离株及其抗生素敏感性模式

Bacterial isolates and its antibiotic susceptibility pattern in NICU.

作者信息

Shrestha S, Shrestha N C, Dongol Singh S, Shrestha R P B, Kayestha S, Shrestha M, Thakur N K

机构信息

Deparment of Pediatrics, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2013 Jan-Mar;11(41):66-70. doi: 10.3126/kumj.v11i1.11030.

Abstract

BACKGROUND

Neonatal sepsis is one of the major causes of morbidity and mortality among the newborns in the developing world.

OBJECTIVES

To determine the common bacterial isolates causing sepsis in neonatal intensive care unit and its antibiotic susceptibility pattern.

METHODS

A one year discriptive prospective study was conducted in neonatal intensive care unit to analyse the results of blood culture and to look into the sensitivity of the commonly used antibiotics.

RESULTS

The blood culture yield by conventional method was 44.13% with nosocomial sepsis accounting for 10.79%. 84.08% were culture proven early onset sepsis and 15.95% were late onset sepsis. Klebsiella infection was the commonest organism isolated in early, late and nosocomial sepsis but statistically not significant. Gram positive organisms were 39.36% in which Staphylococcus aureus was the leading microorganism followed by coagulase negative staphylococcus areus. Gram negative organisms were 60.64% amongst them Klebsiella was the most often encountered followed by Pseudomonas. The most common organism Klebsiella was 87.5% and 78.3% resistance to ampicillin and gentamycin respectively. Among gram negative isolates 87.5% and 77.2% were resistance to ampicillin and gentamycin respectively. Among gram positive isolates 58.5% and 31.5% resistance were noted to ampicillin and gentamycin respectively. Resistance to cefotaxim to gram negative and gram positive isolates were 87.34% and 59.35% respectively.

CONCLUSION

Klebsiella is most common organism which is almost resistance to first line antibiotics. Resistance to both gram negative and gram positive isolates among firstline antibiotics and even with cefotaxim is emerging and is a major concern in neonatal intensive care unit.

摘要

背景

新生儿败血症是发展中国家新生儿发病和死亡的主要原因之一。

目的

确定新生儿重症监护病房引起败血症的常见细菌分离株及其抗生素敏感性模式。

方法

在新生儿重症监护病房进行了为期一年的描述性前瞻性研究,以分析血培养结果并研究常用抗生素的敏感性。

结果

传统方法的血培养阳性率为44.13%,医院感染性败血症占10.79%。84.08%为血培养确诊的早发型败血症,15.95%为晚发型败血症。克雷伯菌感染是早发型、晚发型和医院感染性败血症中最常见分离出的病原体,但无统计学意义。革兰氏阳性菌占39.36%,其中金黄色葡萄球菌是主要微生物,其次是凝固酶阴性葡萄球菌。革兰氏阴性菌占60.64%,其中克雷伯菌最常见,其次是铜绿假单胞菌。最常见的病原体克雷伯菌对氨苄西林和庆大霉素的耐药率分别为87.5%和78.3%。革兰氏阴性菌分离株对氨苄西林和庆大霉素的耐药率分别为87.5%和77.2%。革兰氏阳性菌分离株对氨苄西林和庆大霉素的耐药率分别为58.5%和31.5%。革兰氏阴性菌和革兰氏阳性菌分离株对头孢噻肟的耐药率分别为87.34%和59.35%。

结论

克雷伯菌是最常见的病原体,几乎对一线抗生素耐药。一线抗生素甚至头孢噻肟对革兰氏阴性菌和革兰氏阳性菌分离株的耐药性正在出现,这是新生儿重症监护病房的一个主要问题。

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