| In recent years,with the advancement of perinatal medicine,the number of premature and low birth weight infants in newborns has increased significantly.The current medical conditions are significantly improved.Although the survival rate of newborns is improved,the incidence of neonatal infections is instead.It has increased from the previous.Because of the current increase in premature and very low birth weight children,long hospital stay,long-term application of broad-spectrum antibiotics,clinical operations,such as: venous catheter,catheter puncture,mechanical ventilation,gastric tube implantation,etc.Greatly increased the chance of neonatal infection.Multi-drug resistance is now a major problem in clinical practice.Although clinically timely training,strengthening standardized medication,strengthening clinical care,and minimizing invasive procedures,the multi-drug resistance rate is still increasing,so the hospital protection is strengthened.It has important clinical significance and is of great significance for avoiding neonatal infection and improving the clinical environment.ObjectiveBy collecting the clinical data of neonates hospitalized in NICU in our hospital for the past 5 years,and counting the source and type of pathogens,the pathogens of neonatal infection were divided into G+ cocci,G-bacilli and fungi,and the ratio of infection of each pathogen was counted.In order to study the trend of pathogens of neonatal infection in recent years,and to compare the resistance ratio of neonatal infectious pathogens to antibiotics,to rationally select antibiotics.Research methodsThis study used retrospective investigation and analysis to review the basic information and pathogens of neonates diagnosed with neonatal infections from the third affiliated hospital of Zhengzhou University from January 2013 to December 2017,and from which the pathogens were cultured from the culture medium.The results of drug susceptibility were divided into 5 groups according to time.All the information was obtained from the case room and laboratory of Zhengdasan Affiliated Hospital.The collected data include: 1.The number of positive pathogens and the pathogens in each year;2.The gender,gestational age,birth weight,hospital stay,time of the machine,and age of the child;2.Bacterial susceptibility data.The study data were analyzed retrospectively using the SPSS 21.0 software package.The normal distribution data were expressed as mean±standard deviation(X±S).The comparison between groups was performed by one-way analysis of variance,and the non-normal distribution measurement data was used for median.The number(interquartile range)indicates that the rank-sum test was used for comparison between groups,and P<0.05 was considered statistically significant.Result 1 General InformationFrom January 2013 to December 2017,a total of 542 children with neonatal infection were diagnosed in NICU,including 342 males(63.10%)and 200 females(36.90%).Male: female = 1.72:1,of which ?28 weeks 69 cases(12.73%);28 weeks-32 weeks 279 cases(51.48%);32 weeks-36 weeks 84 cases(15.50%);36-42 weeks 110 cases(20.29%),The gestational age and birth weight of the children showed a gradual decline,and the difference was statistically significant(P<0.05).The hospitalization time and the time of the machine showed a gradual increase trend,the difference was statistically significant(P<0.05),and the age There is no statistical significance.2 Clinical dataMore than 70% of neonates admitted to our hospital's NICU are premature infants.Neonatal infections are mainly respiratory infections,accounting for 60.52%.Venous blood,urine,stool,cerebrospinal fluid,end of respiratory catheter,end of blood catheter and other detected strains.There were 169 cases(31.18%),6 cases(1.11%),4 cases(0.74%),12 cases(2.21%),4 cases(0.74%),8 cases(1.48%),and 11 cases(2.03%).3 Distribution and change of pathogenic bacteriaFrom the culture of 542 cases of pathogens,a total of 429 Gram-negative bacilli,52 Gram-positive cocci,and 61 fungi were detected.Among the Gram-negative bacilli,Klebsiella pneumoniae was the main cause,241 cases,accounting for 44.46%.The remaining major G-bacteria including Acinetobacter baumannii(67 cases of 15.62%)and Pseudomonas aeruginosa(15 cases of 3.50%)),Klebsiella pneumoniae(26 cases 6.29%),Escherichia coli(38 cases 8.86%),and Gram-negative bacilli showed a trend of increasing year by year,and Klebsiella pneumoniae also showed an increasing trend;The proportion of blue-positive cocci decreased,and the fungus showed a steady trend.4 Drug resistance analysis and changesCurrently,three types of antibiotics are mainly used in the NICU ward of our hospital: penicillins,cephalosporins and carbapenem antibiotics.It can be seen from the drug susceptibility test in the past five years that the resistance of pathogens to these three types of antibiotics is gradually Increased;although the incidence of gentamicin,cotrimoxazole,levofloxacin is low,the resistance rate of pathogens to these types of antibiotics is still increasing;among them,Klebsiella pneumoniae to piperacillin tazobactam The resistance rate of cefoperazone and sulbactam increased from 21.75% to 85.71%,and the resistance rate to carbapenems increased from 0% to 81.63%,followed by Acinetobacter baumannii,which was applied to Pella The resistance rate of cilostazol and cefoperazone sulbactam increased from 22.22% to 52.38%,and the resistance rate to carbapenems increased from 0 to 42.86%.It was not found inGram-positive cocci.Pathogenic bacteria resistant to linezolid,teicoplanin,and vancomycin;no resistant fungi resistant to fluconazole,amphotericin B,and flucytosine were found in the fungus,and fungi resistant to itraconazole was found.Conclusion1.In recent years,the neonatal infection rate has been increasing year by year.2.The pathogens in our hospital's NICU are mainly Gram-negative bacilli.Among them,Klebsiella pneumoniae is the most common,showing an increasing trend year by year;Gram-positive cocci are decreasing year by year,and the fungal change trend is relatively stable.3.The resistance rate of pathogenic bacteria to antibiotics increases year by year,and there is a significant high resistance rate to carbapenem antibiotics. |
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