作　　者： ;

机构地区： 深圳大学妇幼保健院

出　　处： 《国际流行病学传染病学杂志》 2018年第5期305-308,共4页

摘　　要： 目的 了解新生儿医院获得性大肠埃希菌血流感染的临床特点及细菌耐药性.方法选择2016—2017年深圳大学妇幼保健院和高州市人民医院诊断为获得性大肠埃希菌血流感染的住院新生儿共23例为研究对象,对患儿的临床特点、抗生素耐药情况、转归及住院费用等进行分析.结果23例患儿常见首发症状为发热（20例）,其次为微量血糖升高（〉7 mmol/L,10例）;呼吸系统损害18例,其中10例发生呼吸衰竭需要呼吸机辅助通气,肺出血2例;循环系统损害5例.10株产ESBLs大肠埃希菌对氨苄西林、头孢曲松、头孢吡肟、头孢唑林、氨曲南、复方磺胺甲噁唑耐药率高于8/10,均高于ESBLs阴性大肠埃希菌（P〈0.05）.ESBLs阳性菌株感染新生儿的住院费用为（2.26±0.91）万元,显著高于阴性者的（1.68±0.83）万元,差异有统计学意义（t=4.62,P〈0.01）.结论发热、呼吸系统体征可作为发现新生儿大肠埃希菌血流感染的早期提示.ESBLs阳性大肠埃希菌感染耐药形势严峻,治疗费用更高. Objective To analyze the clinical features and bacterial drug resistance of hospital-acquired Es-cherichia coli （E.coli） bloodstream infection in neonates. Methods From 2016 to 2017, 23 inpatients with hospi-tal-acquired E.coli bloodstream infection from Shenzhen University Maternal and Child Health Hospital and Gaozhou People＇s Hospital were studied. The basic disease, clinical characteristics, antibiotic resistance,outcomes and hos-pital costs were analyzed. Results Among the 23 cases, the most common symptom was fever （20 cases）, fol-lowed by an elevating of blood glucose （〉7 mmol/L,10 cases）. There were 18 cases of respiratory system damage, including 10 cases of respiratory failure requiring ventilator-assisted ventilation and 2 cases of pulmonary hemor-rhage. Circulatory system damages were found in 5 cases. A total of 10 ESBLs-positive E. coli strains were checked out, and more than 80% of which were resistant to ampicillin, ceftriaxone, cefepime, cefazolin, aztreonam and compound sulfamethoxazole. The resistant rates were all higher than those of ESBLs-negative E.coli strains （P〈0.05）. The hospitalization cost of ESBLs-positive strain infected neonates was higher than that of the ESBLs-negative strains [（2.26±0.91）×10^4 yuan vs （1.68±0.83）×10^4 yuan, t=4.62, P〈0.01]. Conclusions Fever and respiratory signs can be considered as early indications of hospital-acquired E.coli bloodstream infection in neonates. The resis-tant rate of ESBLs-positive E. coli strains is high, and the treament costs more.

关 键 词： 婴儿 院内感染 大肠埃希菌 败血症

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