資源描述:
《新生兒肺炎克雷伯菌肺炎53例臨床特點(diǎn)及藥敏分析》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。
1、四川醫(yī)學(xué)2010年8月第31卷(第8期)SichuanMedicalJournal,2010,Vo1.31,No.8·l1l3·論著新生兒肺炎克雷伯菌肺炎53例臨床特點(diǎn)及藥敏分析彭好,李琴,蘭田,袁濤(遂寧市中心醫(yī)院兒科,四川遂寧629000)【摘要】目的探討新生兒肺炎克雷伯菌肺炎的臨床特點(diǎn)及藥敏情況,了解肺炎克雷伯茵超廣譜13內(nèi)酰胺酶(Es—BLs)的發(fā)生率。方法收集本院2006年1月~2009年12月新生兒肺炎克雷伯菌肺炎53例痰液標(biāo)本,行細(xì)菌培養(yǎng)、鑒定及藥敏試驗(yàn),并行ESBLs撿測(cè)。對(duì)其臨床資料進(jìn)行回顧性分析。結(jié)果新生兒肺炎克雷伯菌肺炎臨床特征無特異性。肺炎克雷伯茵ESBLs的檢出率為3
2、9.62%。社區(qū)獲得性感染與院內(nèi)感染的肺炎克雷伯茵產(chǎn)酶率分別為30.77%,64.29%。肺炎克雷伯茵對(duì)亞胺培南敏感率100%。對(duì)頭孢西丁的敏感率顯著高于其他頭孢類抗生素。產(chǎn)ESBLs菌株耐藥性比非產(chǎn)ESBLs菌株強(qiáng)。結(jié)論新生兒肺炎克雷伯茵肺炎院內(nèi)感染的肺炎克雷伯茵產(chǎn)ESBLs率及耐藥率高于社區(qū)獲得性感染。亞胺培南、頭孢西丁可作為我科新生兒肺炎克雷伯茵肺炎的首選藥物?!娟P(guān)鍵詞】新生兒;克雷伯茵肺炎【中圖分類號(hào)】R722.135【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1004-0501(2010)08—1l13-03Analysisofclinicalfeaturesanddrugsensitivityof
3、53newborninfantstlIldebsiellapneumoniae.PENGHao.LIQin,LANTian,eta1.TheCentralHospitalofSuining,Suining,Sichuan629000,China【Abstract】ObjectiveToexploretheclinicalcharacteristicsanddrugsensitivityofnewbornpneumoniaofklebsiellapneumoniae,andinvestigatethepositiverateofextended-spectrumBlaetamases(ESBLs
4、)inklebsiellapneumoniae.MethodsFifty—threecascsofsputumsamplesnewbompneumoniaofklebsiellapneumoniaefromJan.2006toDec.2009werecollected.Bacteriaidentificationanddrugsensitivitytestwereperformed.Atthesametime,ESBLsweredetected.ResultsTheclinicalcharacteristicsofnewbornpneumonieofklebsiellapneumoniaewe
5、renonspecial,andthepositiverateofESBLsinklebsiellapneu—moniaewas39.62%.ThepositiveratesofESBLsinHAPwere64.29%and30.77%inCAP(P<0.05).Theklebsiellapneu—moniaewas100%sensitivietoearbopenems,butresistanttocommonlyusedpenicillinandcephalosporin.Klebsiellapneumoniaehadhighersensitivitytoeefaxitinethantoot
6、hercommonlyusedcephalosporin.ESBLsnegativestrainshadhigherdrugsensitivitythanESBLsstrains.ConclusionThepositiveratesofESBLsinklebsiellapneumoniaeinHAPwashJ;gherthaninCAP.Totreatklebsiellapneumoniaeinourneonatedepartment,earbopenemsandeefaxitinemaybefirstchoice.【Keywords】infant;klebsiellapneumoniae隨著
7、抗生素的廣泛使用,近年來?xiàng)l件致病菌肺炎例,可聞及中粗或中細(xì)濕噦音31例。胸片表現(xiàn)為斑點(diǎn)克雷伯菌引起新生兒肺炎有增加趨勢(shì)。有統(tǒng)計(jì)資料表狀38例,絮狀8例,伴肺不張5例,肺氣腫2例,合并明?肺炎克雷伯菌肺炎既是社區(qū)獲得性感染又是院敗血癥5例。內(nèi)感染的主要病原。此菌部分為產(chǎn)超廣譜p內(nèi)酰胺1.2標(biāo)本采集和檢測(cè)方法:社區(qū)獲得性肺炎,均于人酶(ESBLs)菌株,耐藥性強(qiáng),治療困難。為提高對(duì)本病院后48h內(nèi)取痰