关键词: 耐药性, 细菌, 新生儿重症监护病房, 抗菌药物

Abstract: Objective To investigate the distribution and drug resistance of common Gram-negative bacteria causing nosocomial infection in neonatal intensive care unit (NICU) and provide the evidence for use of antibiotic reasonably. Methods The samples of sputum,blood,urine and so on from 1 221 inpatients with suspicious infectious diseases in NICU of the authors' hospital were collected,cultured and isolated during the period from January 2014 to June 2016.Antimicrobial susceptibility testing was carried out using instrumental automated analysis system or Kirby-Bauer Method and their susceptibility data were analyzed according to CLSI standard. Results A total of 235 Gram-negative bacilli strains were isolated from 2 133 specimens and accounted for 56.5%(235/416)in all isolated pathogenic bacterial strains.The top five pathogens were Escherichia coli (29.8%),Klebsiella pneumoniae (28.9%),Pseudomonas aeruginosa (13.2%),Acinetobactor baumannii (6.1%),and Stenotrophomonas maltophilia (5.9%).The isolation rates of Escherichia coli and Klebsiella pneumoniae with positive extended-spectrum beta-lactamases (ESBLs) were 45.7% (32/70) and 39.7% (27/68),respectively.The drug resistance rates of those two bacteria to aztreonam,cefepime,ceftriaxone,cefotaxime,tobramycin and ampicillin were considerably higher (53.1%~100%) but significantly lower to antimicrobial supplemented with beta-lactamases-inhibitors.No strains of Escherichia coli or Klebsiella pneumoniae was found resistant to carbapenem.However,the resistance rates of Pseudomonas aeruginosa,Acinetobactor baumannii and Stenotrophomonas maltophilia to imipenem were 16.1%,21.4%,and 100%,respectively.Besides,all Gram-negative bacilli retained highly susceptibility to ciprofloxacin or levofloxacin. Conclusion The major pathogens in NICU of authors' hospital is Gram-negative bacilli.Regular monitoring and rational evaluation about distribution and drug resistance of bacteria may provide the evidence for empirical application of antimicrobial drugs and contribute to the reduction of antibiotic resistance.

Key words: drug resistance, bacteria, neonatal intensive care unit, antibiotics