Pathogen Distribution And Bacteria Resistance Of Neonatal Severe Pneumonia

Objective: To investigate the distribution of pathogen and bacterial resistance of neonatal severe pneumonia.Methods: The data of 510 neonates diagnosed with neonatal pneumonia hospitalized between March 2018 and March 2019 were analyzed retrospectively.According to the diagnosis of neonatal pneumonia,they were divided into severe group(n=257)and common group(n=253).The differences of the distribution of pathogen 、bacterial resistance and risk factor of neonatal severe pneumonia development was analyzed.Results: 1.The proportion of neonates with low birth weight,congenital heart disease,prematurity,age of onset <7 days,anemia,bacterial and viral co-infection in severe group are higher than that in common group,and the mean birth weight in severe group is lower than common group(P < 0.05).2.A total of 161 strains of pathogen were detected from 257 cases of neonatal with severe pneumonia,including 89 strains of bacteria,63 strains of virus,and 9 strains of atypical pathogen(6 strains of pertussis,2 strains of chlamydia trachomatis and 1 strain of chlamydia urealyticum).Gram negative bacteria(83 strains,51.6%)were the dominant bacteria.The top two bacteria were Klebsiella pneumoniae and Escherichia coli.The dominant virus was respiratory syncytial virus(59 strains,36.6%).The positive rates of ESBLs in Gram-negative bacteria were 48.4%.The difference of RSV and ESBLs was statistically significant between two groups(P < 0.05).3.In the severe group,the proportion of RSV in the age of onset>7 days was significantly higher than that in the age of onset ≤ 7 days(P <0.05).4.The independent risk factors for the development of severe neonatal pneumonia include premature delivery,age of onset <7 days,anemia and bacteria co-infection with virus.5.The resistance of Klebsiella pneumoniae in severe group to ampicillin,cefotaxime,ceftazidime and cefepime were higher than those in common group(P < 0.05).The resistance of Escherichia coli to ampicillin in severe group was higher than that in common group,the difference was statistically significant(P < 0.05).There was no significant difference in the sensitivity of the two groups to other antibiotics.Conclusion:The dominant pathogen of neonatal severe pneumonia was Gram-negative bacteria.Klebsiella pneumoniae and Escherichia coli are dominant bacteria.RSV is the main virus.risk factors for the development of severe neonatal pneumonia include premature,age of onset <7 days,anemia and bacteria co-infection with virus.If bacterial infection is considered,we can empirically use enzyme inhibitor compound antibiotics such as piperacillin tazobactam.