Distribution and Drug Resistance of Pathogens in Neonates with Lower Respiratory Tract Infection_West China Medical Journal

Authors：

 KUANGLing-han , WANGJia-min , ZHOUWei ,  JIANGYong-mei

Clinical Laboratory Department, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

JIANGYong-mei, Email: jiangyongmei-1@163.com

Keywords：

Lower respiratory tract infection; Pathogen; Drug resistance; Neonate

DOI：

10.7507/1002-0179.20140126

Video：

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Objective To investigate the distribution and drug resistance of pathogens in neonates with lower respiratory tract infection, and provide evidence for clinical rational antibiotic use. Methods A retrospective analysis on 998 strains isolated from 5 486 sputum samples during January 1, 2009 to December 31, 2012 collected from hospitalized neonates was performed. Results Of the 998 isolated strains, the common pathogens were Klebsiella pneumoniae (23.1%), Escherichia coli (E. coli) (21.2%), Staphylococcus aureus (19.4%), and Enterobacter cloacae (8.4%). Klebsiella pneumonia, E. coli and Enterobacter cloacae were generally resistant to penicillin, but enzyme inhibitors could reduce the resistance rate. A large proportion of Klebsiella pneumonia was resistant to the third generation cephalosporins (78.4%), while E. coli and Enterobacter cloacae had a lower resistance rate (46.7% and 46.5%, respectively). There were 7 strains (3.0%) of Klebsiella pneumoniae and 1 (1.2%) strain of Enterobacter cloacae resistant to imipenem. Twenty-three strains (13.6%) of Klebsiella pneumoniae, 1 strain (0.7%) of E.coli and 1 strain (2.5%) of Enterobacter cloacae were resistant to ertapenem. A total of 97.0% of Staphylococcus aureus was resistant to penicillin, but only 11.0% was resistant to oxacillin, and all the isolates were sensitive to vancomycin. Conclusion Gram negative bacteria are the common pathogens in the hospitalized neonates in our hospital. Klebsiella pneumonia, E. coli and Staphylococcus aureus are the common pathogens. The common pathogens show a high resistant level to antibiotics. Clinicians should evaluate the potential pathogens of infections based on the results presented in our study, in order to select antibiotics rationally when treating infections.

Citation： KUANGLing-han, WANGJia-min, ZHOUWei, JIANGYong-mei. Distribution and Drug Resistance of Pathogens in Neonates with Lower Respiratory Tract Infection. West China Medical Journal, 2014, 29(3): 417-420. doi: 10.7507/1002-0179.20140126 Copy

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2. 葉應嫵, 王毓三, 中華人民共和國衛生部醫政司. 全國臨床檢驗操作規程[M]. 2版. 南京:東南大學出版社, 1997:754-869.
3. Rudan L, Boschi-Pinto C, Biloglav Z, et al. Epidenmiology and etiology of childhood pneumonia[J]. Bull World Health Organ, 2008, 86(5):408-416.
4. Centers for Disease Control and Prevention. Staphylococcus aureus with reduced susceptibility to vancomycin-Illinois, 1999[J]. MMWR Morb Mortal Wkly Rep, 2000, 48(51-52):1165-1167.
5. 張金峰. 2005-2010年小兒下呼吸道感染病原菌分布及耐藥性分析[J]. 中華醫院感染學雜志, 2012, 22(8):1745-1747.
6. 李曉瑜, 陳東平, 莊思齊, 等. 26例新生兒肺炎克雷伯菌感染的臨床特征及藥敏分析[J]. 中國當代兒科雜志, 2003, 5(5):461-463.
7. 周清德, 繆競智, 張秀珍. 產ESBL肺炎克雷伯菌醫院感染分子流行病學研究[J]. 中華醫院感染學雜志, 2000, 10(1):10-12.
8. 林慶安, 羅文侗, 修清玉, 等. 超廣譜β-內酰胺酶肺炎克雷伯菌大腸埃希菌耐藥監測[J]. 中華檢驗醫學雜志, 2001, 24(4):10.
9. Centers for Disease Control and Prevention. Staphylococcus aureus resistant to vancomycin-United States, 2002[J]. MMWR Morb Mortal Wkly Rep, 2002, 51(26):565-567.
10. Centers for Disease Control and Prevention. Brief report:vancomycin resistant Staphylococcus aureus New York, 2004[J]. MorbMortal Wkly Rep, 2004, 53(15):322-323.
11. 李家泰, Weinstein A, 楊敏, 等. 中國細菌耐藥監測研究[J]. 中華醫學雜志, 2001, 81(1):11-19.
12. B?swald M, D?big C, K?ndler C, et al. Pharmacokinetic and clinical evaluation of serious infections in premature and newborn infants under therapy with imipenem/cilastatin[J]. Infection, 27(4/5):299-304.
13. 汪復. 產β-內酰胺酶耐藥菌感染的防治策略[J]. 中華傳染病雜志, 2000, 18(3):4-5.
14. 聶川, 張永, 羅先瓊, 等. 新生兒病房陰溝腸桿菌感染及藥敏結果分析[J]. 臨床兒科雜志, 2011, 29(9):825-828.

West China Medical Journal

Distribution and Drug Resistance of Pathogens in Neonates with Lower Respiratory Tract Infection

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