Zhang Xin, Li Yang, Tao Yunzhen, Ding Yu, Shao Xuejun, Li Wei
Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, China.
Front Microbiol. 2022 Mar 10;13:820577. doi: 10.3389/fmicb.2022.820577. eCollection 2022.
To analyze the pathogen distribution and drug resistance of newborns with bloodstream infection (BSI) to help clinicians choose the appropriate empirical antibiotic therapy for clinical infection control.
A total of 707 neonatal BSI cases were retrospectively analyzed. The bacteria in blood culture-positive samples were cultured, identified, and analyzed for drug sensitivity by routine methods. Statistical software was used to compare and analyze the basic data, pathogenic information, and drug resistance of the main bacteria.
The 5-year average positive rate of neonatal blood culture was 2.50%. The number of specimens submitted for inspection in 2020 significantly decreased. The top five infectious pathogens with the highest proportion were coagulase-negative (67.35%), of which had the highest proportion (31.26%), followed by (12.87%), (9.05%), (8.63%), and (3.25%). Gram-positive (G) bacteria were dominant, accounting for 69.45%. The main G bacteria had a higher rate of resistance to erythromycin and penicillin G. The main Gram-negative (G) bacteria had a high resistance rate to a variety of antibacterial drugs, especially cephalosporin antibiotics. The overall resistance of was higher than that of . The top two fungi detected were and did not appear to be resistant to antibiotics, while was resistant to multiple antibiotics. The type of microbial infection had a statistically significant difference in the positive rate among the age at delivery and wards ( < 0.05). There were significant differences in the detection of fungi among these groups ( < 0.05). The positive rate of G bacteria in the term newborns was significantly higher than that in the preterm newborns ( < 0.05). Preterm newborns are more susceptible to pneumonia.
G bacteria are the main pathogens of neonatal BSI. Preterm newborns are more likely to be infected with G bacteria. and are the most common G bacteria, and both have a high resistance rate to a variety of antibacterial drugs. According to the distribution characteristics and drug resistance, it is very important to select antibiotics reasonably.
分析血流感染（BSI）新生儿的病原菌分布及耐药情况，以帮助临床医生选择合适的经验性抗生素治疗方案，用于临床感染控制。
回顾性分析707例新生儿BSI病例。对血培养阳性标本中的细菌进行常规培养、鉴定及药敏分析。采用统计软件对主要细菌的基本数据、致病信息及耐药情况进行比较分析。
新生儿血培养5年平均阳性率为2.50%。2020年送检标本数量显著减少。感染比例最高的前5种病原体依次为凝固酶阴性菌（67.35%），其中[具体菌名1]比例最高（31.26%），其次为[具体菌名2]（12.87%）、[具体菌名3]（9.05%）、[具体菌名4]（8.63%）和[具体菌名5]（3.25%）。革兰阳性（G⁺）菌占主导，为69.45%。主要G⁺菌对红霉素和青霉素G耐药率较高。主要革兰阴性（G⁻）菌对多种抗菌药物耐药率高，尤其是头孢菌素类抗生素。[具体菌名6]的总体耐药性高于[具体菌名7]。检出的前两种真菌为[具体真菌名1]和[具体真菌名2]，[具体真菌名1]似乎对抗生素不耐药，而[具体真菌名2]对多种抗生素耐药。微生物感染类型在分娩年龄和病房间的阳性率有统计学差异（P<0.05）。这些组间真菌检出有显著差异（P<0.05）。足月儿G⁺菌阳性率显著高于早产儿（P<0.05）。早产儿更易患肺炎。
G⁺菌是新生儿BSI的主要病原菌。早产儿更易感染G⁺菌。[具体菌名1]和[具体菌名2]是最常见的G⁺菌，且对多种抗菌药物耐药率均高。根据病原菌分布特点及耐药情况合理选用抗生素非常重要。
