河南省 2020–2022 年新生儿病原菌分布及耐药性分析

Distribution and Drug Resistance of Neonatal Pathogens in Henan Province from 2020 to 2022

摘要:

〔摘 要〕 目的：分析河南省 112 所医院 2020–2022 年新生儿病原菌的分布及耐药性，为新生儿抗菌药物的临床合理应 用提供依据。 方法：收集河南省细菌耐药监测网中有关新生儿病原菌分布及耐药性检测的资料数据，采用 WHONET 2020 进行数据分析。 结果：2020–2022 年共检出病原菌总数为 3221 株，其中革兰阴性菌（G^- ）1935 株（60.1 %），革兰阳性菌 （G⁺ ）1286 株（39.9 %）。G^- 检出前 3 位是肺炎克雷伯菌 610 株（18.9 %），大肠埃希菌 415 株（12.9 %），鲍曼不动杆 菌 184 株（5.7 %）；G^{+ 检出前 3 位是金黄色葡萄球菌 549 株（17.0 %），表皮葡萄球菌 235 株（7.3 %），屎肠球菌 170 株 （5.3 %）。2020–2022 年河南省新生儿感染的病原菌的构成比较稳定，以 G- 为主，肺炎克雷伯菌对头孢噻肟等多种抗菌药 物呈现较高的耐药性，大肠埃希菌对氨苄西林的耐药率在 2020 年及 2021 年均超过 80 %，鲍曼不动杆菌对阿莫西林 / 克拉 维酸的耐药率在 2020 年达到了 67.3 %。G+ 中，2020–2022 年，金黄色葡萄球菌和凝固酶阴性葡萄球菌对青霉素 G 的耐药 率均高于 90 %，未检测出耐万古霉素的金黄色葡萄球菌和凝固酶阴性葡萄球菌。 结论：河南省新生儿患者的病原菌主要是 G- ，个别病原菌耐药情况较严重，临床医师应及时了解区域内病原菌的流行趋势，根据药敏检测的结果选择合适的抗菌药， 医院应加强常见病原菌的耐药监测和防控，保障医疗安全。}

Abstract:

〔Abstract〕 Objective To analyze the distribution and drug resistance of pathogens isolated from neonates in 112 hospitals in Henan Province from 2020 to 2022, and to provide a basis for the rational use of antibiotics in neonates. Methods The data of the distribution and drug resistance of pathogenic bacteria in neonates were collected from the bacterial resistance surveillance network of Henan Province, and WHONET 2020 was used for data analysis. Results A total of 3,221 strains of pathogens were detected from 2020 to 2022, including 1935 strains (60.1 %) of Gram-negative bacteria (G- ) and 1286 strains (39.9 %) of Gram-positive bacteria (G+ ). The top three G- strains were 610 strains of Klebsiella pneumoniae (18.9 %), 415 strains of Escherichia coli (12.9 %), and 184 strains of Acinetobacter baumannii (5.7 %). The top three G+ strains were 549 strains of Staphylococcus aureus (17.0 %), 235 strains of Staphylococcus epidermidis (7.3 %), and 170 strains of Enterococcus faecium (5.3 %). From 2020 to 2022, the composition of pathogenic bacteria in neonatal infections in Henan Province remained relatively stable, mainly G- . Klebsiella pneumoniae displayed high resistance to various antibacterial drugs such as cefotaxime. The resistance rate of Escherichia coli to ampicillin exceeded 80 % in 2020 and 2021, and the resistance rate of Acinetobacter baumannii to amoxicillin/ clavulanic acid reached 67.3 % in 2020. Among the G+ strains, the resistance rates of Staphylococcus aureus and coagulase negative Staphylococcus to penicillin G were higher than 90 % from 2020 to 2022, and no vancomycin-resistant Staphylococcus aureus or coagulase negative Staphylococcus was detected. Conclusion The main pathogens of neonatal patients in Henan Province are G- , and the drug resistance of some pathogens is serious. Clinicians should timely understand the epidemiological trends of pathogenic bacteria in the region, and select appropriate antibacterial drugs according to the results of drug sensitivity testing.