新生儿败血症的病原菌构成及降钙素原水平分析

Analysis of Pathogen Composition and Level of Procalcitonin in Neonatal Sepsis

摘要: 目的：研究新生儿败血症病原菌、药敏情况及降钙素原(PCT)水平，为败血症性质判定及抗生素使用提供临床依据。方法：回顾性收集医院2017年1月至2020年12月间新生儿重症监护病房收治的血培养阳性的新生儿败血症患儿的临床资料及实验室检查，对其病原菌构成、药敏情况以及PCT水平进行统计分析。结果：共165份阳性血培养，共培养出病原菌168株；其中革兰阳性菌87株，以凝固酶阴性葡萄球菌为主；革兰阴性菌80株，以大肠埃希菌为主。药敏结果显示，革兰阳性菌对青霉素、红霉素普遍耐药；革兰阴性菌对头孢菌素耐药性较高，对碳青霉烯类敏感性高。结论：大肠埃希菌、凝固酶阴性葡萄球菌、肠球菌是新生儿败血症的主要病原菌，且对常用抗生素有一定抗性。降钙素原可对败血症病原菌性质判定提供线索。

Abstract: Objective: To study the pathogenic bacteria, drug sensitivity and PCT level of neonatal sepsis, so as to provide clinical basis for the determination of the nature of sepsis and the use of antibiotics. Methods: Clinical data and laboratory examination of blood culture-positive neonatal septicemia children admitted to neonatal intensive care unit from January 2017 to December 2020 were collected retrospectively, and statistical analysis was conducted on the composition of pathogenic bacteria, drug sensitivity and PCT level. Results: A total of 165 positive blood cultures were obtained, and 168 strains of pathogenic bacteria were cultured. There were 87 gram-positive bacteria, mainly coagulase-negative Staphylococcus. There were 80 gram-negative bacteria, mainly Escherichia coli. The results showed that gram-positive bacteria were generally resistant to penicillin and erythromycin. Gram-negative bacteria are more resistant to cephalosporin and more sensitive to carbapenems. Conclusion: Escherichia coli, coagulase-negative Staphylococcus and Enterococcus are the main pathogens of neonatal sepsis, and have certain resistance to common antibiotics. Procalcitonin can provide clues for the determination of the nature of pathogenic bacteria in sepsis.