新生儿肺炎克雷伯菌败血症96例临床药敏分析

程亚利

（陕西省延安市人民医院，陕西 延安，716000）

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摘要：

目的 探讨96例新生儿肺炎克雷伯菌败血症临床药敏分析情况。方法 对我院新生儿科2014年2月至2016年3月收治的96例肺炎克雷伯菌败血症新生儿临床药敏结果进行系统性回顾分析。结果 90例患儿1次血培养阳性，6例患儿第2次复查血培养仍阳性；102株肺炎克雷伯菌中检出ESBLs 菌株25株，占24.5%；肺炎克雷伯菌败血症临床表现多样化，常见的症状有黄疸、发热、纳差、精神差、消化道症状，早发症状与晚发症状除了黄疸有差异外（P<0.05），其他临床表现均无差 异（P>0.05）；亚胺培南、美洛培南是治疗新生儿肺炎克雷伯菌败血症最为敏感的药物，其次为阿米卡星、头孢西丁、头孢哌 酮/舒巴坦、哌拉西林/他唑巴坦、阿莫西林/棒酸，肺炎克雷伯菌对大多数青霉素及头孢类抗生素敏感性不高。经敏感药物治疗后，患儿治愈率达70.8%，患儿好转率达29.2%；在治疗过程中未出现过敏及其他不良反应情况。结论 亚胺培南、美洛培南 对肺炎克雷伯菌敏感度高，可作为治疗新生儿肺炎克雷伯菌败血症的首选药。

关键词：新生儿；肺炎；克雷伯菌败血症；药敏分析

中图分类号：R446.5文献标志码：A文章编号：2096-1413(2016)27-0031-02

Drug sensitivity analysis of klebsiella pneumoniae septicemia in 96 newborns
CHENG Ya-li
(Yan`an People`s Hospital, Yan`an 716000, China)

ABSTRACT: Objective To investigate the drug sensitivity of klebsiella pneumoniae septicemia in 96 newborns. Methods Ninety-six cases of newborns with klebsiella pneumoniae septicemia treated in our hospital from February 2014 to March 2016 were selected as study subjects, and their drug sensitivity was retrospectively analyzed. Results Ninety cases had one time positive blood culture, 6 cases still had positive blood culture in the second review; 25 strains of ESBLs were detected in 102 strains of klebsiella pneumoniae, which accounted for 24.5% ; klebsiella pneumoniae septicemia had diversified clinical features, and the main clinical symptoms included jaundice, fever, poor appetite, poor spirit, digestive tract and so on. The difference of jaundice before and after treatment had statistical significance (P<0.05), while other clinical symptoms had no difference (P >0.05); lmipenem, meropenem were the most sensitive drugs for treating klebsiella pneumoniae septicemia, the selondary was amikacin, cefoxitin, cefoperazone/sulbactam, piperacillin/tazobactam, amoxicillin/acid，the sensibility of klebsiella pneumoniae septicemia with most penicillin and spore class antibiotic was not high. With sensitive drug treatment, the cure rate of patients was 70.8%, the improvement rate was 29.2%, and there was no irritability and other adverse reactions occurring during treatment. Conclusion Lmipenem, meropenem have high sensibility on klebsiella pneumoniae septicemia and can be seen as principal drugs for newborn with klebsiella pneumoniae septicemia.
KEYWORDS: newborn; pneumonia; klebsiella sepsis; antifungal susceptibility

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