新生儿败血症病原学变迁及耐药性的临床研究

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1、1硕士学位论文新生儿败血症病原学变迁及耐药性的临床研究院（系）、所临床医学院研究生姓名邓茂文学科、专业儿科学导师姓名董文斌教授二O一二年四月目录新生儿败血症病原学变迁及耐药性的临床研1究„„„„„„„„„„„„„„121.1中文摘要„„„„„„„„„„„„„„„„„„„„„11.2英文摘要„„„„„„„„„„„„„„„„„„„„„31.3前言„„„„„„„„„„„„„„„„„„„„„„„51.4对象与方法„„„„„„„„„„„„„„„„„„„„61.5结果„„„„„„„„„„„„„„„„„„„„„„„71.6讨论„„„„„„„„„„„„„„„„„„„„„„„121.7结论„„„

2、„„„„„„„„„„„„„„„„„„„„201.8参考文献„„„„„„„„„„„„„„„„„„„„„201.9英汉缩略词对照表„„„„„„„„„„„„„„„„„242附录„„„„„„„„„„„„„„„„„„„„„„„243致谢„„„„„„„„„„„„„„„„„„„„„„„253新生儿败血症病原菌及耐药性研究的现状（综述）及参考文献„„„„„„„„„„„„„„„„„„„„„„„„„264论文独创性声明及发表承诺书„„„„„„„„„„„„39摘要目的探讨泸州医学院新生儿败血症2002年1月到2011年10月的病原学及耐药性特点，以期达到对临床的诊治和预防的指导。方3法通过对泸州医学

3、院新生儿败血症2002年到2011年10月收治133例血培养阳性的新生儿败血症的病原学及耐药性进行回顾性分析。并比较前五年和后五年的病原学及耐药性特点。结果在282例血培养标本中，阳性病例133例，阳性率为47.16%，其中占首位的致病菌为表皮葡萄球菌,有40例，占30.77%，其次致病菌依次分别为溶血葡萄球菌(16例，占12.03%)、金黄色葡萄球菌(9例，占6.77%)、大肠埃希氏菌(9例，占6.77%)，其中真菌感染3例,占2.26%。表皮葡萄球菌、溶血葡萄球菌、大肠埃希氏菌后五年感染率明显增加，革兰阳性球菌对青霉素、头孢唑啉、红霉素、庆大霉素、苯唑青霉素的耐药性高，而且

4、后五年较前五年更高；对林可霉素、环丙沙星、左氧氟沙星、亚胺培南、氧哌嗪青霉素他唑巴坦的耐药性较高，而且后五年较前五年更高；对万古霉素敏感性高，但2011年有1例耐万古霉素金黄色葡萄球菌。革兰阴性杆菌对氨苄青霉素、头孢唑啉耐药率高，对亚胺培南高度敏感。结论新生儿败血症的病原菌主要是葡萄球菌，其中最主要是凝固酶阴性的葡萄球菌（Coagulase-NegativeStaphylococciCoNS），革兰阴性菌中大肠埃希菌呈上升趋势。关键词新生儿；败血症；病原学；耐药性；分析ClinicalStudyOnPathogenicFluxAndDrugResistanceOfNeonata

5、lSepsisGraduateStudent:Deng-mao-wenAbstract:objective:TostudythecharacteristicofetiologyanddrugresistanceofneonatalsepsisinLuzhouMedicalCollegefromJanuaryin42002toOctoberin2011forrationaluseantibioticsinclinic.methods:ToreviewanalysisetiologyanddrugresistanceofneonatalsepsisinLuzhouMedicalCo

6、llegefromJanuaryin2002toOctoberin2011,andcomparethecharacteristicofetiologyanddrugresistanceofneonatalsepsisbetweenfirstfiveyearsandsecondfiveyears.results:In282bloodcultureexamples,thereare133mascclinecases,mascclineratiois47.16%.AmongpathogenicbacteriumthefirstetiologyisStapylococcusepider

7、midis，Therearefortyexamplesandaccount30.77percent.ThesecondisStapylococcushaemolyticusandaccountssixteenexamplesand12.03percent.ThethirdisEscherichiacoliandStapylococcusaureusandtheyareallnineexamplesandaccount6.77percent.Amongpathogenicbacteriumth