论文部分内容阅读
目的分析胎膜早破新生儿口腔分泌物细菌的分布特点、耐药情况以及不同分娩方式的细菌分离阳性率,为临床合理的预防性使用抗生素提供科学的指导。方法对2011年1月至2012年12月广东省妇幼保健院新生儿科送检的116份胎膜早破新生儿口腔分泌物标本进行细菌培养,并以法国梅里埃的全自动细菌鉴定药敏系统(VITEK-2 compact)对分离出的纯菌株进行鉴定和药敏试验,统计不同分娩方式的阳性率。结果 116份口腔分泌物标本中,共分离出细菌33株/31例,总检出率为26.7%,其中G-菌28株,占84.8%,G+菌5株,占15.2%,检出率最高的细菌是大肠埃希菌17株(51.5%),其除了对丁胺卡那霉素、头孢替坦和亚胺培南全部敏感以外,对其他的抗生素均有不同程度的耐药,两种分娩方式的细菌培养阳性率差异无统计学意义(P=0.491)。结论胎膜早破新生儿口腔分泌物培养以G-菌为主且耐药性较高,临床应根据药敏结果合理选用抗生素进行预防用药;在无医学指针的情况下,推荐阴道分娩。
OBJECTIVE: To analyze the distribution characteristics, drug resistance and the positive rate of bacterial isolation in different modes of delivery in neonates with premature rupture of membranes, and provide scientific guidance for clinical use of prophylactic antibiotics. Methods A total of 116 specimens of neonates with premature rupture of membranes obtained from the Department of Neonatology, Maternal and Child Health Hospital of Guangdong Province from January 2011 to December 2012 were subjected to bacterial culture. Based on the automated bacterial identification system (VITEK-2 compact) were isolated pure strains identified and drug susceptibility tests, statistical methods of positive rate of different modes of delivery. Results Of the 116 samples of oral secretions, 33 were isolated from bacteria and 31 were detected, with a total detection rate of 26.7%, of which 28 were G-bacteria, accounting for 84.8% and 5 were G + bacteria, accounting for 15.2% The highest bacterium was Escherichia coli 17 strains (51.5%), in addition to the amikacin, cefotetan and imipenem all sensitive, other antibiotics have different levels of resistance, two There was no significant difference in the positive rate of bacterial culture in the mode of delivery (P = 0.491). Conclusions Neonatal premature rupture of membranes of oral secretions culture with G-bacteria-based and high resistance, clinical should be based on drug susceptibility results rational use of antibiotics for prophylaxis; in the absence of medical guidelines, recommended vaginal delivery.