■新生儿在医院特别容易受到感染,新生儿败血症是最常见的感染症状,也是新生儿死亡的第三大原因。肺炎克雷伯菌是肠杆菌科的革兰氏阴性细菌,这是新生儿败血症的常见病原体。在这项研究中,我们将分析和评估现状,临床特征,新生儿重症监护病房(NICU)肺炎克雷伯菌感染的耐药性,目的是在临床实践中为及时、准确的临床诊断和治疗提供有效依据。
■对2020年1月至2022年6月上海市某妇产科专科医院NICU收治的75例婴幼儿肠杆菌科败血症进行统计分析。根据细菌鉴定,分离株分为肺炎克雷伯菌(KP)组(n=49)和非KP肠杆菌科组(n=26)。感染,临床特征,比较两组感染患者的细菌耐药情况。
■比较两组的临床特征,结果显示,KP和非KP组中的大多数受试者是早产儿,占科目的100%和92.3%,分别;迟发性是两组的主要疾病,占科目的93.9%和80.8%,分别。所有患者均接受经外周置入中心导管(PICC)。与非KP组相比,KP组的降钙素原和CRP(C反应蛋白)水平明显升高(p<0.05)。同时,KP组血小板减少发生率明显高于非KP组(p<0.05)。KP组抗菌药物暴露比例高于非KP组。KP组对头孢他啶的耐药性,头孢曲松,头孢吡肟,氨苄西林/舒巴坦,氨曲南,环丙沙星和复方磺胺甲恶唑明显高于非KP组,而对头孢替坦的耐药率,庆大霉素和去布霉素明显低于非KP组,统计学差异显著(p<0.05)。对38例产ESBLs的肺炎克雷伯菌进行相关耐药基因检测。结果表明,主要的电阻类型为SHV和TEM,检出率分别为60.6%和28.9%。
■这项研究表明,由肺炎克雷伯菌感染引起的新生儿败血症在早产和低出生体重儿中具有较高的发病率和耐药性,成为严重的公共卫生问题,临床医生应重视鉴别诊断,合理选用抗生素,减少耐药菌的产生。
UNASSIGNED: Newborns are particularly susceptible to infection in hospitals, with neonatal sepsis being the most common infection symptom and the third leading cause of neonatal death. Klebsiella pneumoniae is a gram-negative bacterium of Enterobacteriaceae, which is a common pathogen of neonatal
septicemia. In this study, we will analyze and evaluate the current status, clinical characteristics, and drug resistance of Klebsiella pneumoniaesepsis infection in Neonatal Intensive Care Unit (NICU), with the aim of providing effective basis for timely and accurate clinical diagnosis and treatment in clinical practice.
UNASSIGNED: Statistical analysis was performed on 75 cases of Enterobacteriaceae
septicemia in infants admitted to NICU in a special obstetrics and gynecology hospital in Shanghai from January 2020 to June 2022. Based on bacterial identification, isolates were divided into the Klebsiella pneumoniae (KP) group (n = 49) and the non-KP Enterobacteriaceae group (n = 26). The infection, clinical characteristics, and bacterial resistance of the two groups of infected patients were compared.
UNASSIGNED: Comparing the clinical characteristics of the two groups, the results showed that most of the subjects in the KP and non-KP groups were premature infants, accounting for 100% and 92.3% of subjects, respectively; late onset was the main disease in both groups, accounting for 93.9% and 80.8% of subjects, respectively. All patients received Peripherally Inserted Central Catheter(PICC). The levels of pro calcitonin and CRP (C-reactive protein) were significantly higher in the KP group compared with those in the non-KP group (p < .05). At the same time, the incidence of thrombocytopenia in the KP group was significantly higher than that in the non-KP group (p < .05). The proportion of antimicrobial drug exposure in the KP group is higher than that in the non-KP group. The drug resistance of the KP group to ceftazidime, ceftriaxone, cefepime, ampicillin/sulbactam, aztreonam, ciprofloxacin and compound sulfamethoxazole was significantly higher than that of the non-KP group, whereas the drug resistance rate to cefotetan, gentamycin and to bramycin was significantly lower than that of the non-KP group, Statistically significant differences (p < .05). 38 cases of Klebsiella pneumoniae producing ESBLs were tested for related resistance genes. The results showed that the main resistance types were SHV and TEM, with detection rates of 60.6% and 28.9%.
UNASSIGNED: This study shows that neonatal sepsis caused by Klebsiella pneumoniae infection has a high incidence and drug resistance in premature and low birth weight infants, and has become a serious public health problem; Clinicians should pay attention to differential diagnosis, Reasonable selection of antibiotics to reduce the generation of drug-resistant bacteria.