Bacterial Distribution,Drug Susceptibility Changes In Sputum Bacteria Culture And Clinical Features Of Neonates With Pneumonia: A Report Of 126 Cases From 2014 To 2016 In Neonatal Ward I And Ⅱ Of Children’s Hospital Of Chongqing Medical University

ObjectiveTo explore the bacterial distribution,drug susceptibility changes in sputum bacteria culture and clinical features of neonates with pneumonia in Neonatal ward I and II of Children’s Hospital of Chongqing Medical UniversityMethodA retrospective analysis was conducted of neonates in Neonatal ward I and II of Children’s Hospital of Chongqing Medical University from January 2014 to December 2016.A total of 126 cases who were diagnosed with neonatal pneumonia and had two or more sputum cultures were enrolled.The distribution and composition ratio of bacteria in sputum specimens,infection rate of main pathogens,drug susceptibility results of conventional antibiotics between Neonatal ward I and II were analyzed and compared.Data were analyzed by SPSS19.0.ResultsThe characteristics of bacteria distribution and their sensitivity to antibiotics in the two wards were as follows:(1)The main pathogens in sputum specimens of Neonatal ward I were Klebsiella pneumonia(25%,including multiple resistant strain 3.6%),Staphylococcus aureus(16.4%,including multiple resistant strain 5.5%),Acinetobacter baumannii(14.5%)and Escherichia coli(10.9%,including multiple resistant strain 1.8%),whereas the main pathogens of Neonatal ward II were Klebsiella pneumonia(35%,including multiple resistant strain 2.5%),Staphylococcus aureus(15%,including multiple resistant strain 10%),Escherichia coli(15%,including multiple resistant strain 15%)and Enterobacter cloacae(10%).No statistically difference was observed in bacteria distribution(X2=17.874,p=0.596>0.05).Additionally,no significant differences were observed in the composition ratio of multidrug-resistant Escherichia coli(p=0.368)and multidrug-resistant Klebsiella pneumonia(p=0.461)between Neonatal ward I and II.(2)Drug susceptibility results: Klebsiella pneumonia showed high resistance to β-lactam antibiotics,especially for cefazolin,cefotaxime,ceftazidime,cefepime,ampicillin,ampicillin sulbactam,of which the resistance ratio was 60-90%.Escherichia coli detected from Neonatal ward II had multiple drug resistance.Staphylococcus aureus was mainly resistant to amoxicillin clavulanic acid and ampicillin,and higher resistance to amoxicillin clavulanic acid(>65%)was observed,whereas no resistance to vancomycin,cephalosporins,aminoglycosides,quinolones,carbapenems was detected.Moreover,Acinetobacter baumannii was mainly resistant to aztreonam and amoxicillin clavulanic acid.ConclusionThe dominant nosocomial infection pathogens of neonates were gram-negative bacterium.Pediatricians should pay more attention to the clinical symptoms of neonates,Take and dynamic monitor the CRP,PCT and sputum culture,clinicians should pay attention to empirical use of antibiotics combined with drug sensitivity tests according to the neonatal clinical manifestations,and it is also important to avoid the broad spectrum of antibiotic abuse.Strengthening hand hygiene,sterile operation and Strict disinfection of the device.To establish a comprehensive range of infection control intervention mechanism and carry out a series of infection control measures.