凝固酶阴性葡萄球菌致新生儿败血症临床分析

目的了解本地区凝固酶阴性葡萄球菌（CNS）致新生儿败血症的病原学及耐药性状况，用以指导临床治疗。方法回顾性分析64株CNS致新生儿败血症血培养的病原学及耐药性。结果64株CNS中以表皮葡萄球菌和溶血葡萄球菌为主；耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）39株，分离率为60．9％，β-内酰胺酶检出率达100％，MRCNS对青霉素、红霉素、苯唑西林耐药率最高，对利福平、呋西地酸、替考拉宁、喹奴普汀／达福普汀等耐药率均较低；甲氧西林敏感凝固酶阴性葡萄球菌（MSCNS）25株，分离率为39．1％，13-内酰胺酶检出率为44％，MSCNS对大多数抗生素敏感；64株CNS中未检测到万古霉素耐药株。结论新生儿败血症中CNS以表皮葡萄球菌和溶血葡萄球菌为主，MRCNS检出率高且呈多重耐药，应重视对其监测与控制。

Clinical analysis of Neonatal septicemia caused by coagulase-negative Staphylococcus

Objective To investigate the etiology and drug resistance of neonatal septicemia caused by coagulase negative Staphylococus （CNS） in this region, and guide the clinical treatment. Methods The blood cultures of 64 strains of neonatal septicemia caused by CNS were analyzed retrospectively for the etiology and drug resistance. Results Among the total 64 strains of CNS isolated, the predominant pathogens were Staphylococcus epidermidis and Staphylococcus hemolyticus. 39 strains （60.9%） were MRCNSs, among which the positive rate of β-1actamase was 100%. The drug-resistance rates of MRCNS strains to penicillin, erythromycin and oxaeillin were higher than those to rifampin, fusidate, teicoplanin and Quinupristin/Dalfopristin. 25 strains （39.1%） were MSCNSs, among which the positive rates of β-1aetamase was 44%. MSCNS strains were sensitive to most of the antibiotics. No van- comycin-resistant strains were found. Conclusion Staphylococcus epidermidis and Staphylococcus hemolyticus are the major CNSs in neonatal septicemia, which show a high detection rate of MRCNS and the MRCNSs are multidrug resistant. Effective control of the pathogens should be strengthened.