新生儿李斯特菌感染15例临床的探讨.docVIP

新生儿李斯特菌感染15例临床的探讨 　　[摘要] 目的 探讨新生儿李斯特菌感染情况，为新生儿李斯特菌临床诊治提供借鉴参考。方法 2014年2月―2016年3月方便收集15例LM感染确诊患儿的临床资料，观察15例患儿发病月份分布情况，对早发型与晚发型患儿的围生期相关指标进行对比，开展血培养及药敏试验，总结LM对常用抗菌药物的耐药情况。结果 1月和11月无患儿发病，4～10月是LM感染的高发期，占全年发病的80.0%；早发型（n=13）和晚发型（n=2）患儿在发病时间及感染途径上差异有统计学意义（P0.05），早发型发病时间5 d，?樽庸?内感染，晚发型发病时间≥5 d，为生后感染；血培养及药敏试验结果显示对左氧氟沙星为100.0%耐药，对万古霉素、利福平、亚胺培南、美罗培南均为100.0%敏感。结论 儿科医师应当加强围生期感染控制，完善血培养及药敏试验，合理选择抗菌药物治疗，提高新生儿LM感染防治水平。 　　[关键词] 新生儿；李斯特菌感染；临床特点 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0084-03 　　[Abstract] Objective This paper tries to investigate the infection of newborn Liszt Rand， to provide the reference for clinical diagnosis and treatment of neonatal Liszt bacteria. Methods From February 2014 to March 2016， the clinical data of 15 patients with LM infection were collected. The distribution of the onset of the disease in 15 children was convenient observed. The perinatal related indicators of early-onset and late-onset children were compared. Blood culture and drug susceptibility tests were carried out to summarize the resistance of LM to common antimicrobial agents. Results In January and November， there was no morbidity in children. From April to October， the incidence of LM infection was high， accounting for 80.0% of the total. The incidence of early-onset （n=13） and late-onset （n=2）， with significant difference（P0.05）. The incidence of early onset was less than 5 d， which was intrauterine infection， onset of late onset was more than 5 d， and was postnatal infection. The results of blood culture and susceptibility test showed that levofloxacin was 100.0% resistant， sensitive to vancomycin， rifampicin， imipenem and meropenem 100.0%. Conclusion Pediatricians should strengthen perinatal infection control， improve blood culture and susceptibility testing， rational choice of antimicrobial drug treatment， improve the prevention and treatment of neonatal LM infection. 　　[Key words] Neonatal； Liszt infection； Clinical characteristics 　　李斯特菌（Listeria monocytogenes，LM）全