| ObjectiveTo analyze the strain types of bacterial or fungal infection and the positive rates of different types of the respiratory tract, blood, cerebrospinal fluid, feces, secretions which are from neonatal intensive care unit (NICU) in Henan Province from2006to2011,the popular bacterial flora of newborn bacteria/fungal infections was mastered in Henan province. At the same time,the drug-resistance of dominant bacteria infection (including gram-negative bacilli and positive cocci)was analyzed to understand the resistance of the main bacterial infection to provide the basis for a reasonable selection for clinical drug and a comprehensive control for nosocomial infection.MethodsIn this research,the specimens of respiratory tract, blood, cerebrospinal fluid, feces, secretions were selected from Henan NICU in the year2006to2011,and they were cultured and tested in vitro drug sensitivity complied with the provisions of the National Clinical Laboratory Procedures (Third Edition), only the first strains in duplicate of the same patient were selected except for different sensitivity rates of the two.Positive strains were identified and MIC susceptibility tested by ATB-Expression combined with manual methods, of which problem strains were checked and verified in vitro susceptibility test by Kirby-Bauer diffusion test, the susceptibility results were determined in accordance with the CLSI standard. According to the instructions,the monitoring data entered the WHONET software,and then bacterial distributions and resistance rates were statistically analyzed by the software.Results3.1Constitution of strains:A total of119,592specimens were received from January2006to December2011in NICU in Henan Province,of which14304pathogens were isolated, including1632fungi, accounting for11.41%,3360Gram-positive bacteria, accounting for23.49%,9312Gram-negative bacteria, accounting for65.10%. Enterobacteriaceae of Gram-negative bacteria accounted for51.26%, non-fermentative bacteria47.44%.Several of the top pathogens of common Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, XM Aeromonas, Pseudomonas aeruginosa,etc;and that of Gram-positive bacteria Staphylococcus aureus ranked first, followed by Staphylococcus epidermidis, Staphylococcus haemolyticus, and Enterococcus faecium.The pathogens of fungal infection were all Candida,with filamentous fungi, zygomycetes, and the two-phase fungi not detected.The respiratory tract infection was in majority. Several of the top of fungi detection were candida albicans, season also have monilia, smooth monilia, Dublin monilia and Portugal candida SPP.Species distributions of specimens of different types are quite different,common bacteria in different samples are as follows:Escherichiato coli, Klebsiella pneumoniae, Klebsiella oxytoca, addicted to XM Aeromonas, Acinetobacter baumannii, Pseudomonas aeruginosa, solution bird, Klebsiella, Enterobacter cloacae, goldStaphy-lococcus aureus in the sputum samples; Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, enterococci, beta-hemolytic streptococcus in the urine sample;coagulase-negative staphylococci, Escherichia coli, Klebsiella pneumoniae bacteria, Staphylococcus aureus, Enterococcus, Candida albicans in the blood samples;hemolytic Streptococcus, Klebsiella pneumoniae, coagulase-negative staphylococci, Staphylococcus aureus in the Secretions, pus, and drainage of fluid samples,and Beta-hemolytic streptococcus, meningeal septic septicemia Flavobacterium, Xie birds Klebsiella, Neisseria meningitidis bacteria in the central nervous system specimens sample.3.2Common Clinical Detection of the Bacterial Drug-resistance3.2.1Gram positive bacteria3.2.1.1StaphylococcusThe detection rates of methicillinresistant staphylococcus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRSCN),and staphylococcus overall methicillin-resistant (MRS) were61.29%,94.19%,82.74%,respectively. We observed that the rate of staphylococci to erythromycin was80.6%staphylococci to SMZ96.8%,and resistant or insensitive strains to vancomycin, teicoplanin and linezolid were not detected.The resistance rate of MRSA to beta-lactam compound drugs, aminoglycosides, fluoroquinolones, tetracyclines, macrolides and other antibiotics was significantly higher than that of MSSA.3.2.2Gram-negative bacilli3.2.2.1Enterobacteriaceae4773Enterobacteriaceae were detected, accounting for51.26%of all gram-negative bacilli.Antimicrobial agents of high antibacterial activity were meropenem (MEM), imipenem(IPM), Ertapenem (ETP), cefoperazone/sulbactam (SCF), piperacillin/tazobactam (of TZP), amikacin (AK), cefepime (FEP) and ceftriaxone (CRO). Enterobacteriaceae were highly resistant to ampicillin, amoxicillin, and piperacillin, and the resistance rates were generally above90%, and were highly resistant to cephalosporin generation, second generation, the resistance rate above70%. The resistance rate of Enterobacteriaceae to cefotaxime was extremely high, all over85%, presumably producing CTX-M-ESBL strains contributing to this,and the resistance rate of Enterobacteriaceae to ceftriaxone was significantly lower than that of other third-generation cephalosporins, which may relate with the use of antimicrobial agents specific of us. Ertapenem and other carbapenems for Enterobacteriaceae still show a high sensitivityand rare resistance rate of only0.17%. Antibacterial drugs of the β-lactam and its complex beta-lactamase inhibitors such as piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF), was sensitive to Enterobacteriaceae bacteria with a rate more than70%,which showed excellent inhibitory activity of synergies.ConclusionWe conclude from the statistical analysis that in neonatal infection Gram-positive ball bacteriuria plays an important part in blood culture samples,while the gram-negative bacilli in respiratory specimens.At the same time,it can not be ignored that we should prevent and alert fungal infections when we take use of,especially prolonged use of,broad-spectrum antimicrobial drug to resist infection, it is of great significance to establish the drug resistance surveillance and early warning mechanisms and interventions for infection of the newborn ward and even for the overall patients in the hospital,which will guide the clinicians scientific selection of antimicrobial drugs and control nosocomial infection. |
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