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Objective To study the risk factors of intestinal bacteria colonization and antibiotic resistance among newborns in neonatal intensive care unit (NICU).Method From May 2014 to May 2015,newborns admitted to NICU in our hospital were enrolled and their feces were prospectively collected and cultured from day 5 to day 7 after birth.VITEK-2 system was used to identify the bacteria and determine their antibiotic susceptibility.Newborns were assigned into 8 groups according to their gestational age,mode of delivery and use of antibiotics,and the colonization rates of Escherichia coli (E.coli),Enterococcus and Klebsiella pneumoniae were compared.Result A total of 572 feces of newborns were collected,328 strains of E.coli,243 strains of Enterococcus and 70 strains of Klebsiella pneumoniae were isolated.The multi-drug resistance rates of E.coli and Enterococcus were 68.3％ (136/199) and 76.1％ (185/243),respectively.The colonization rates of E.coli,Enterococcus and Klebsiella pneumoniae of the full-term delivery without antibiotics group (77 cases),full-term Cesarean section (C-section) without antibiotics group (30 cases),premature C-section without antibiotics group (28 cases),premature delivery without antibiotics group (16 cases),premature delivery with antibiotics group (53 cases),full-term delivery with antibiotics group (155 cases),full-term C-section with antibiotics group (99 cases),premature C-section with antibiotics group (114 cases) were different.The antibiotics groups showed significantly less E.coli colonization rates and higher Enterococcus colonization rates than the non-antibiotics groups of the same gestational age and delivery mode (P ＜ 0.05).The result between the full-term C-section newborns and naturally delivered newborns without antibiotics indicated the similar trend (P ＜ 0.05).The colonization rates of Klebsiella pneumoniae showed no significant differences among the groups (P ＞ 0.05).Conclusion The multi-drug resistance of E.coli and Enterococcus in neonatal intestinal colonization is common and worrisome.Bacterial colonization is affected by antibiotics and the mode of delivery and prudent use of antibiotics is advised.
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Streptococcus pneumoniae is the leading pathogen of community-acquired infections in children, and can cause invasive and noninvasive diseases.Due to the overuse of extensive use of antimicrobial agents in recent years, the problem of drug resistance of Streptococcus pneumoniae caused by the resistance clone alternatives becomes increasingly serious.The promotion of vaccine and rational use of antibiotics play an important role in controlling the spread of drug-resistant clones of Streptococcus pneumoniae.
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Serogroup 6 Streptococcus pneumoniae is one of the common serogroups that lead to community acquired infections in children, and was divided into 6A and 6B serotypes by quellung reaction.With the application of typing methods by gene sequencing, new serotypes such as 6C, 6D, 6E, 6F and 6H have been discovered in recent years.The increase of 6C subtype in the countries or regions after the introduction of pneumococcal conjugated vaccine(PCV)7 should be emphasized.In this paper, the capsular polysaccharide synthesis genes, structure of capsular polysa-ccharide, antimicrobial resistance and molecular epidemiology of new serotypes of serogroup 6 Streptococcus pneumoniae were discussed.
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Objective To understand the antibiotic resistance of bacteria colonized in intestine of the neonates from neonatal intensive care unit (NICU) and provide evidence to guide clinical antibiotic treatment.Methods From May,2014 to May,2015,a total of 572 stool samples were collected from the neonates of NICU in our hospital.Escherichia coli and Enterococcus were detected with VITEK-2 system.Results A total of 328 strains of E.coli and 243 strains of Enterococcus were isolated respectively in this study.The 199 strains of E.coli selected for drug susceptibility test showed lower resistant rate to imipenem,ertapenem,amikacin,nitrofurantoin,ranging from 0.50％ to 3.52％ and showed higher resistant rate to ampicillin,tetracycline,trimethoprim/sulfamethoxazole and cefazolin,ranging from 54.27％ to 84.92％.No meropenem resistant strainsere were found.The percentage of ESBLs production strains was 45％.The multi drug resistance test showed that 34.6％ of the strains were resistant to four antibiotics.Three strains were resistant to seven antibiotics.The 243 strains of Enterococcus showed lower resistant rate to quinupristin/dalfopristin,nitrofurantoin,streptomycin,ranging from 0.41％ to 4.53％ and showed higher resistant rate to ampicillin,benzylpenicillin,ciprofloxacin,tetracycline,gentamicin and erythromycin,ranging from 70.78％ to 91.77％.No strains which were resistant to tigecycline,vancomycin,rina thiazole amine/ketone were found.The multi drug-resistance test showed that 86.5％ of the strains were resistant to five antibiotics.Conclusions According to the analysis of the 199 strains ofE.coli and 243 strains of Enterococcus isolated from the neonates,we found that the resistance of intestinal bacteria in the neonates was very serious,showing multi drug resistance.It is necessary to use antibiotics according to the drug susceptibility test results in clinical treatment.
RESUMEN
Objective To understand the antibiotic resistance of bacteria colonized in intestine of the neonates from neonatal intensive care unit (NICU) and provide evidence to guide clinical antibiotic treatment.Methods From May,2014 to May,2015,a total of 572 stool samples were collected from the neonates of NICU in our hospital.Escherichia coli and Enterococcus were detected with VITEK-2 system.Results A total of 328 strains of E.coli and 243 strains of Enterococcus were isolated respectively in this study.The 199 strains of E.coli selected for drug susceptibility test showed lower resistant rate to imipenem,ertapenem,amikacin,nitrofurantoin,ranging from 0.50％ to 3.52％ and showed higher resistant rate to ampicillin,tetracycline,trimethoprim/sulfamethoxazole and cefazolin,ranging from 54.27％ to 84.92％.No meropenem resistant strainsere were found.The percentage of ESBLs production strains was 45％.The multi drug resistance test showed that 34.6％ of the strains were resistant to four antibiotics.Three strains were resistant to seven antibiotics.The 243 strains of Enterococcus showed lower resistant rate to quinupristin/dalfopristin,nitrofurantoin,streptomycin,ranging from 0.41％ to 4.53％ and showed higher resistant rate to ampicillin,benzylpenicillin,ciprofloxacin,tetracycline,gentamicin and erythromycin,ranging from 70.78％ to 91.77％.No strains which were resistant to tigecycline,vancomycin,rina thiazole amine/ketone were found.The multi drug-resistance test showed that 86.5％ of the strains were resistant to five antibiotics.Conclusions According to the analysis of the 199 strains ofE.coli and 243 strains of Enterococcus isolated from the neonates,we found that the resistance of intestinal bacteria in the neonates was very serious,showing multi drug resistance.It is necessary to use antibiotics according to the drug susceptibility test results in clinical treatment.