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目的:探讨新生儿大肠埃希菌败血症的药物敏感特点,为合理治疗提供临床依据。方法:对成都市儿童医院新生儿科2007年1月～2010年12月收治的临床怀疑败血症的新生儿血标本进行培养、分离、鉴定,选择培养结果为大肠埃希菌的病例作药敏及临床分析。结果:40例大肠埃希菌对碳青霉烯类抗生素敏感率达100%,对头孢西丁敏感率达75.0%,对含酶抑制剂抗生素如哌拉西林/他唑巴坦、替卡西林/克拉维酸敏感率为87.5%,对新生儿较少应用的氨基糖苷类、喹诺酮类抗生素敏感率为62.5%～93.8%。对较常用的青霉素、头孢菌素均不敏感,对氨苄西林完全耐药。产超广谱β-内酰胺酶(ESBLs)菌株有逐步上升趋势,晚发型高于早发型,但晚发型治疗效果较早发型好。结论:新生儿大肠埃希菌败血症临床症状无特异性,但可伴严重的并发症,部分大肠埃希菌为产ESBLs菌株,耐药性强,对一般抗生素不敏感,故应根据药敏实验结果,指导选择敏感抗生素,以控制疾病发展,降低病死率。
Objective: To explore the drug-sensitive characteristics of Escherichia coli septicemia in neonates and provide a clinical basis for rational treatment. Methods: The blood samples of neonates with suspected clinical septicemia who were admitted to Department of Neonatology, Children’s Hospital of Chengdu from January 2007 to December 2010 were cultured, isolated and identified. The results of culture were selected as drug susceptibility and clinical manifestations of Escherichia coli analysis. Results: The susceptibility of 40 Escherichia coli strains to carbapenems was 100%, and the sensitivity to cefoxitin was 75.0%. The antibiotics such as piperacillin / tazobactam, ticarcillin / Clavulanic acid sensitivity of 87.5%, less application of newborns aminoglycosides, quinolone antibiotics susceptibility was 62.5% to 93.8%. More commonly used penicillin, cephalosporin are not sensitive to ampicillin completely resistant. ESBLs-producing strains showed a gradual upward trend, late-onset type was higher than early-onset type, but late-onset treatment had a better hair style. Conclusion: Neonatal Escherichia coli sepsis clinical symptoms are nonspecific, but may be associated with serious complications, part of Escherichia coli ESBLs producing ESBLs strains, strong resistance, insensitive to general antibiotics, it should be based on susceptibility testing The results guide the choice of sensitive antibiotics to control disease progression and reduce mortality.