137例新生儿败血症临床分析

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1、137例新生儿败血症临床分析朱玉芳张爱珍常德市第一人民医院新生儿科，湖南常德415700[摘要]目的探讨新生儿败血症的临床特点、病原菌分布及抗生素耐药状况，指导早期诊断、合理防治。方法选择该院新生儿科住院诊断为新生儿败血症的137例病例，对其临床表现、致病菌及药敏试验进行回顾性分析。结果该院诊断败血症病例中血培养阳性率为64.2%。革兰氏阳性菌占72.2%，金黄色葡萄球菌与表皮葡萄球菌分别占43.3%和15.6%，对苯唑西林的耐药率分别为48.7%、42.9%，对青霉素、红霉素耐药率较高，对美罗培南、替考拉宁、万古霉素耐药率较低。革兰氏阴性菌中大

2、肠埃希菌占首位。早期新生儿败血症与晚期新生儿菌种比较，早期败血症革兰氏阴性菌感染率高于晚期，晚期败血症革兰氏阳性菌感染率高于早期，两者比较差异有统计学意义。结论葡萄球菌为该院新生儿败血症主要致病菌；应做好孕期感染的防治，加强围产期及新生儿期保健，以减少新生儿败血症的发生；新生儿可选抗生素少，应根据临床表现，结合药敏合理用药。.jyqkiaZHUYufangZHANGAizhenDepartmentofNeonatology，TheFirstPeople’sHospitalofChangde，Changde，HunanProvince，415700

3、，China[Abstract]ObjectiveToinvestigatetheclinicalcharacteristicsofneonatalsepticemiasadmittedinourhospital，andthedistributionofpathogenscausingneonatalsepticemiaandtheirantibioticresistancesoastoguidetheearlydiagnosisandrationalpreventionandtreatment.MethodsTheclinicaldataof1

4、37casesofneonatesdiagnosediainDepartmentofNeonatologyofourhospitalfromJanuary，2009toJanuary，2013ia，thepositivebloodculturerate-positivebacteriaaccountedfor72.2%，ofidisaccountedfor15.6%.Theratioofoxacillin-resistantstaphylococcusaureusandS.epidermidisycin，buthadloeropenem，teic

5、oplanin，vanycin.Escherichiacolionggram-negativebacteria.Intheparisonofearlyneonatalsepticemiaandlateneonatalspecies，theformerhadahighergram-negativebacteriainfectionratethanthelatter，andthelatterhadahighergram-positivebacteriainfectionratethantheformer，thedifferencebetainpath

6、ogenofneonatalsepticemiasinourhospital.Infectionshouldbepreventedandtreatedduringpregnancy，andthehealthcareinperinatalandneonatalperiodshouldbestrengthenedsoastoreducetheoccurrenceofneonatalsepticemia.Antibioticsforneonatesarelimited，sorationaladministrationshouldbebasedonthe

7、clinicalmanifestationsandantimicrobialsusceptibilitytests.[Keyia；Pathogen；Antibioticresistance[简介]朱玉芳（1980.10-），女，湖南常德人，硕士，主治医师，研究方向：新生儿疾病，邮?aclass="__cf_email__"href="/cdn-cgi/l/email-protection"data-cfemail="b3571009cac6d5d2ddd4808385f38285809dd0dcde">[email protected]

8、。新生儿败血症是新生儿常见的危重症，是新生儿死亡的主要原因之一。该病早期临床表现常不典型，症状体征缺乏特异性，给早期诊断带来困难，为总结