| Multidrug resistant bacteria(multi-drug resistant organism,MDRO)mainly refer to bacteria that are resistant to three or more types of antibiotics used clinically.With the improvement of medical level,antibiotics are widely used in clinical practice.Bacterial resistance has become the primary problem in clinical anti-infective treatment.Multidrug resistant bacteria have occupied an important position in the pathogens of nosocomial infection.The specific immunity and non-specific immunity of newborns are not yet mature,which is more prominent in premature infants,and premature infants have more invasive operations,resulting in premature infants are more prone to infection,and the risk of infection with multidrug-resistant bacteria increases.Due to the characteristics of autoimmune function in term infants,as well as the lack of aseptic awareness and inadequate care of family members,multiple drug-resistant bacterial infections also occur.Multidrug resistant bacteria infection is difficult to treat,if the treatment is not timely,not standardized and even endanger the safety of life.Therefore,the study on the clinical characteristics of multidrug-resistant bacteria in premature infants and full-term infants in neonatal intensive care unit(neonatal intensive care unit,NICU)can provide a theoretical basis for early clinical identification and rational drug use,and also provide a theoretical basis for controlling hospital infection and improving neonatal health care.Objective:By comparing and analyzing the distribution and drug resistance of multidrug-resistant bacteria strains in premature infants and full-term infants in neonatal intensive care unit,it provides a theoretical basis for early clinical rational diagnosis and treatment,and improves the level of hospital infection prevention and control and neonatal health care.Methods:A total of 72 children with multidrug-resistant bacteria(MDRO)infection admitted to the neonatal intensive care unit of the Affiliated Hospital of Chengde Medical College from January 2014 to December 2019 were enrolled in the study.According to gestational age,they were divided into premature group(gestational age < 37 weeks)and full-term group(37weeks≤gestational age < 42 weeks).The non-specific infection indicators,infection and culture sites,main pathogens and drug sensitivity of the subjects were collected.The difference between the two groups was compared,and P < 0.05 was considered to be statistically significant.Results:The proportion of MDRO in umbilical secretions in term infants group was higher than that in preterm infants group,and the proportion of MDRO in tracheal intubation tube end in preterm infants group was higher than that in term infants group,the difference was statistically significant(P < 0.05).There was no significant difference in non-specific infection indexes between the two groups(P > 0.05).Gram-negative bacteria were the main multidrug-resistant bacteria in premature infants,and ESBLs-producing Klebsiella pneumoniae accounted for the largest proportion(33.2 %).Gram-positive bacteria were the main multidrug-resistant bacteria in term infants,and methicillin-resistant Staphylococcus aureus(MRSA)accounted for the largest proportion(54.8 %).The difference between the two groups was statistically significant(P < 0.05).MRSA was completely resistant to penicillin and oxacillin(100 %);The resistance rates to clindamycin,cefazolin,erythromycin and cefoxitin were high(> 80 %);Resistance rates to amikacin,levofloxacin,rifampicin,tetracycline,moxifloxacin,ciprofloxacin and gentamicin were low(< 30 %);No drug-resistant strains were detected for linezolid,nitrofurantoin,teicoplanin,vancomycin,tigecycline,and quinuptin-dafopritine.ESBLs-producing Klebsiella pneumoniae was the main Gram-negative bacteria and was completely resistant to cefazolin,ampicillin-sulbactam and cefuroxime(all 100 %).High resistance rates to nitrofurantoin,amoxicillin,ceftazidime,ceftriaxone,cefotaxime and cefamandole(> 60 %);The resistance rates to gentamicin,ciprofloxacin,cefoperazone,cefoperazone sulbactam,cefepime and tigecycline were low(< 40 %);No resistant strains were found to amikacin,levofloxacin,tazobactam,imipenem and meropenem.Conclusion:The infection site,pathogenic bacteria distribution and drug resistance of multidrug-resistant bacteria in neonates of different gestational ages are different.It is necessary to distinguish them in clinical practice for rational drug use. |
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