新生儿败血症病学变迁及耐药性的临床研究.pdfVIP

2 1.1 中文摘要„„„„„„„„„„„„„„„„„„„„„1 1.2 英文摘要„„„„„„„„„„„„„„„„„„„„„3 1.3 前言„„„„„„„„„„„„„„„„„„„„„„„5 1.4 对象与方法„„„„„„„„„„„„„„„„„„„„6 1.5 结果„„„„„„„„„„„„„„„„„„„„„„„7 1.6 讨论„„„„„„„„„„„„„„„„„„„„„„„12 1.7 结论„„„„„„„„„„„„„„„„„„„„„„„20 1.8 参考文献„„„„„„„„„„„„„„„„„„„„„20 1.9 英汉缩略词对照表„„„„„„„„„„„„„„„„„24 2 附录„„„„„„„„„„„„„„„„„„„„„„„24 3 致谢„„„„„„„„„„„„„„„„„„„„„„„25 3 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 „„„„„„„„„„„„„„„„„„„„„„„„„26 4 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-Negative Staphylococci CoNS ），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 Clinical Study On Pathogenic Flux And Drug Resistance Of Neonatal Sepsis Graduate Student :Deng-mao-wen Abstract: objective : To study the characteristic of etiology and drug resistance of neonatal sepsis in Luzhou Medical College from January in 4 2002 to October in 2011 for rational use antibiotics in clinic. methods: To review analysis etiology and drug resistance of neonatal sepsis in Luzhou Medical College from January in 2002 to October in 2011,and compare the characteristic of etiology and drug resistance of neonatal sepsis between first five years and second five years. results: In 282 blood cultur