Analysis Of Pathogen And Drug Sensitivity In Neonates With Either Community-Acquired Pneumonia Or Hospital-Acquired Pneumonia

Objective:To investigate the distribution of the pathogen and its drug sensitivity in neonates with community acquired pneumonia or hospital acquired pneumonia in Chongqing area.Methods:Retrospective study on the clinical data of 3908 cases of neonatal pneumonia with smear positive of Chongqing Medical University Children’s Hospital from January 2010 to December 2014.Results:1. 4383 pathogenic strains were detected from the specimens of 3564 neonates in CAP, including 3584 strains were bacteria,771 strains were virus,7 strains were fungi and 21 strains were atypical pathogens. Gram-negative bacteria(3045 strains, 85.0%)were the major pathogen bacteria, The top three bacteria were Kpn(937 strains, 21.39%),E.coli(733 strains, 16.72%) and SA(455strains,10.38%).Gram-negative bacteria(3045 strains, 85.0%) were the major pathogen bacteria, and respiratory Syncytial virus(693strains, 89.9%) was the main pathogen viruses in newborns in CAP. 424 pathogenic strains were detected from the specimens of 344 neonates in HAP, including 402 strains were bacteria,17 strains were fungi,5 strains were respiratory viruses. Gram-negative bacteria are the main strains, no gram-positive bacteria was found, the top three gram-negative bacteria were Kpn(201 strains, 47.3%), E.coli(56 strains, 13.2%) and AB(51 strains, 12.0%).2. 819(26.9%) strains produced extended spectrum beta-lactamases(ESBLs) in CAP and 188(46.8%) strains produced ESBLs in HAP. Respectively, the positive rate of ESBLs in HAP was higher than CAP(P<0.05).3. The drug sensitivity of Kpn and E.coli both in CAP and HAP were highly sensitive to amikacin,carbapenems.The sensitivity of Kpn in HAP was generally lower to commonly used antimicrobial agents(except amikacin and quinolones) than that of CAP, the difference has statistical significance(P< 0.05). The sensitivity of E.coli in HAP was generally lower to commonly used antimicrobial agents(except amikacin, quinolones and carbapenems) than that of CAP, the difference has statistical significance(P<0.05).4. In addition, carbapenem-resistant Enterobacteriaceae was found.Conclusion:Gram-negative bacteria are the major pathogen of neonatal pneumonia. Among them, CAP was dominated by Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus, while HAP was mainly dominated by Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumanni. The enzyme-producing rate and drug resistance of HAP were generally higher than CAP, and there was a trend of multidrug resistance.