Analysis Of Pathogen Distribution And Drug Resistance In Blood Culture And Sputum Culture In NICU For Five Years

Objective:Based on the positive results of blood culture or sputum culture in neonatal NICU(Neonatal intensive care unit),the distribution characteristics of pathogenic bacteria and changes of drug sensitivity of neonatal sepsis and neonatal pneumonia were investigated respectively,so as to provide the best solution for the treatment of the disease and reasonable basis for clinical drug application,strengthen the prevention and control of the disease and improve the prognosis.Methods:A retrospective study was conducted.The pathogenic bacteria species,drug sensitivity results and clinical data of children diagnosed with neonatal sepsis and neonatal pneumonia from blood culture or sputum culture positive results in the NICU of the First People’s Hospital of Yunnan Province from January 2015 to December2019 were collected.SPSS25.0 software was used for statistical analysis,in which measurement data were expressed as mean±standard deviation((?)±S),and t test was used for comparison between groups.Enumeration data rate(%)indicated that χ2 or corrected χ2 test was used for comparison between groups.p< 0.05 was statistically significant.Results:1.The main pathogens of EOS(Early-onset sepsis)were Gram-negative bacteria(69/121,57.0%),CNS(Coagulase negative staphylococcus)(39/121,32.2%),Burkholderia glacolus(26/121,21.5%)and Escherichia coli(15/121,12.4%).The main pathogens of LOS(Late-onset sepsis)were gram-positive bacteria(28/45,62.2%),CNS(22/45,48.9%),Escherichia coli(6/45,13.3%)and Klebsiella pneumoniae(6/45,13.3%).The detection rate of CNS showed a decreasing trend from2015 to 2019,and no Staphylococcus aureus was detected after 2017.2.In neonatal sepsis,common gram-positive bacteria had high resistance rates to penicillins,clindamycin and macrocyclic endolipids,while no strains resistant to vancomycin and linezolid were detected.The common gram-negative bacteria showed high resistance to ampicillin and low resistance to antimicrobial drugs containing β-lactamase inhibitor complexes,carbapenems and aminoglycosides.3.Gram-negative bacteria were dominant in CAP(Community-acquired pneumonia)and HAP(Hospital-acquired pneumonia),accounting for 85.4% and84.0% respectively.The main pathogenic bacteria of CAP were Escherichia coli(92/152,51.7%),Klebsiella(28/152,15.7%)and Acinetobacter baumannii(11/152,6.2%).The main pathogens causing HAP were Klebsiella(33/94,35.1%),Escherichia coli(13/94,13.8%)and Enterobacter cloacae(13/94,11.7%).From 2015 to 2019,the detection rate of Escherichia coli showed a decreasing trend,while the detection rate of Acinetobacter baumannii showed an increasing trend.4.In neonatal pneumonia,common gram-positive bacteria had high resistance rates to penicillins and clindamycin antibiotics,while no strains resistant to ertapenem,teicolanin,tegacycline and vancomycin were found.The resistance rate of common gram-negative bacteria to ampicillin was high,and the resistance rate to cephalosporin three or four generations,quinolones,aminoglycosides and carbapenicillin antibiotics was low.Conclusions:1.From 2015 to 2019,CNS was the main pathogen of neonatal sepsis.Vancomycin and linezolid are available for Gram-positive bacteria infection.Antibiotics containing β-lactamase inhibitor complex and carbapenems are available for Gram-negative bacteria infection.2.From 2015 to 2019,Gram-negative bacteria were the main pathogenic bacteria in neonatal pneumonia,among which Escherichia coli was the main pathogenic bacteria.The drug resistance rate of β-lactam antibiotics is generally high among pathogenic bacteria,and the antibiotics containing β-lactamase inhibitor complex and carbapenems can be selected for clinical use.3.The change of the detection rate of main pathogenic bacteria in neonatal sepsis in recent five years was considered to be related to the standard application ofβ-lactamase inhibitor complex antibiotics and vancomycin.4.The changes of Escherichia coli detected in neonatal pneumonia in recent five years were considered to be related to the use of antibiotics containing β-lactamase inhibitor complex and carbapenems.The changes of Acinetobacter baumannii were considered to be related to the resistance of the bacteria to carbapenems.