Analysis of distribution and antibiotic resistance of 233 positive results of blood cultures in neonatal intensive care unit / 中国小儿急救医学

ABSTRACT

Objective To investigate the pathogens distribution and their drug resistance of blood culture-positive neonates with sepsis in neonatal intensive care unit(NICU) and to provide evidence for clinically reasonable use of antibiotics.Methods One thousand four hundred and fifty neonates admitted to our NICU of Affiliated Hospital of Guangdong Medical College from Jan 2009 to Jul 2011 were enrolled.The blood samples from 1 450 neonates were cultured and isolated,and all of the isolates and their resistances were analyzed retrospectively.Results A total of 9 species and 233 pathogenic strains were isolated from 1 450 specimens,and the positive rate was 16.1％.Among the 233 strains,93 strains were gram-positive cocci,103 strains were gram-negative bacilli,and 37 strains were fungus.Among gram-positive cocci,the most dominant organism was coagulase negative staphylococcus,the next was Staphylococcus aureus;while among gram-negative bacilli,Ktebsiella pneumoniae were the most frequently isolated,the next were Escherichia coli and Acinetobacter baumannii,and among the fungus,monilia were the most isolated.The resistance rates of gram-positive cocci to vancomycin,linezolid and teicoplanin were high.Moreover,the antibiotic resistance rates to penicillin,oxazocilline and the β-lactamase were more than 95％.Gram-negative bacilli were sensitive to levofloxacin,imipenem and meropenem.A majority of fungus was Monilia,which was sensitive to antifungal.Conclusion Coagulase negative staphylococcus,Klebsiella pneumoniae and Escherichia coli are the the most common pathogens of neonatal sepsis in NICU,and have high drug resistance.Clinicians should select sensitive drug treatment according to bacterial identification and susceptibility testing.Besides,mycotic infection cannot be ignored and merit our attention.