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新生儿医院感染败血症中分离的微生物的微生物学特征和抗生素敏感性变化趋势:14 年分析。

Changing trend of microbiologic profile and antibiotic susceptibility of the microorganisms isolated in the neonatal nosocomial sepsis: a 14 years analysis.

机构信息

Department of Neonatology Karadeniz Technical University, Trabzon, Turkey.

Department of Clinical Microbiology, Karadeniz Technical University, Trabzon, Turkey.

出版信息

J Matern Fetal Neonatal Med. 2020 Nov;33(21):3658-3665. doi: 10.1080/14767058.2019.1582633. Epub 2019 Mar 4.

DOI:10.1080/14767058.2019.1582633
PMID:30760078
Abstract

Neonatal sepsis, especially nosocomial sepsis (NS) is one of the main causes of mortality and morbidity in neonates. Our aim was to investigate microorganisms responsible for NS and antimicrobial susceptibility patterns and to compare them in a different period. Blood culture registers from the Microbiology Laboratory were reviewed for the study population. The neonates with proven NS were enrolled in the study. Microorganisms responsible for NS and antimicrobial susceptibility patterns were recorded The incidence of Gram-positive, Gram-negative, and fungal microorganisms were 61.6% ( = 570), 27.1% ( = 251) and 11.3% ( = 104), respectively. The most common isolated Gram-positive, Gram-negative pathogens and fungi were Coagulase-negative staphylococci (CoNS), and . There was an increasing resistance rate among common nosocomial pathogens especially oxacillin resistant CoNS strains and increasing rate for extended-spectrum beta-lactamase (ESBL) positive microorganisms. Low susceptibility was detected to commonly used antibiotics for empirical treatment in neonatal sepsis. Our result showed that multiresistant microorganisms, especially oxacillin-resistant staphylococci and gram-negative bacilli resistant to cephalosporin have an increasing rate. Every unit should evaluate the causative agents and antimicrobial susceptibilities in order to select an appropriate regime for nosocomial sepsis. Periodic surveillance of organisms and their antibiotic resistance patterns in every unit might help physicians for proper selection of antibiotics for treatment of neonatal NS.

摘要

新生儿败血症,尤其是医院获得性败血症(NS)是新生儿死亡和发病的主要原因之一。我们的目的是研究导致 NS 的微生物以及抗菌药物敏感性模式,并比较不同时期的情况。从微生物实验室的血培养登记册中回顾了研究人群。将确诊为 NS 的新生儿纳入研究。记录导致 NS 的微生物和抗菌药物敏感性模式。革兰阳性菌、革兰阴性菌和真菌微生物的发生率分别为 61.6%(=570)、27.1%(=251)和 11.3%(=104)。最常见分离的革兰阳性菌、革兰阴性病原体和真菌分别为凝固酶阴性葡萄球菌(CoNS)和。常见的医院获得性病原体,尤其是耐苯唑西林的 CoNS 菌株和产超广谱β-内酰胺酶(ESBL)的微生物的耐药率呈上升趋势。对于新生儿败血症的经验性治疗,常用抗生素的敏感性较低。我们的结果表明,多耐药微生物,尤其是耐苯唑西林的葡萄球菌和对头孢菌素耐药的革兰阴性杆菌的发生率呈上升趋势。每个单位都应评估病原体和抗菌药物敏感性,以选择合适的医院获得性败血症治疗方案。在每个单位定期监测病原体及其抗生素耐药模式可能有助于医生为新生儿 NS 的治疗选择合适的抗生素。

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