院内感染新生儿肺炎病原菌分布特点及干预对策

目的了解院内感染新生儿肺炎病原菌分布的特点，并分析原因和探讨干预对策。方法回顾性分析义乌市中心医院新生儿监护病房（NICU）2012年6月至2013年6月发生的60例院内感染新生儿肺炎患儿的痰液标本细菌培养及药敏资料，了解病原菌分布的特点，分析引起院内感染新生儿肺炎的原因，并采取相应的干预对策。结果60例患儿样本共培养出病原菌72株，其中革兰阳性菌20株，占27．8％，主要是金黄色葡萄球菌、草绿色链球菌与表皮葡萄球菌，革兰阴性菌52株，占72．2％，主要是肺炎克雷伯菌、大肠埃希菌和鲍曼不动杆菌。金黄色葡萄球菌中6株为耐甲氧西林金葡菌（MRSA），占50％，肺炎克雷伯菌中13株为多重耐药菌，占56．5％，大肠埃希菌中6株为多重耐药菌，占46．2％，鲍曼不动杆菌中4株为多重耐药菌，占66．7％，铜绿假单胞菌中2株为多重耐药菌，占50％，嗜麦芽类单胞菌与阴沟肠杆菌均为多重耐药菌。结论院内感染新生儿肺炎病原菌分布以革兰阴性菌为主，多重耐药菌比例较高，通过有效的干预措施，可以降低院内感染新生儿肺炎的发病率。

The pathogen distribution and intervention strategy for hospital acquired neonatal pneumonia

Objective To learn the distribution of pathogens causing hospital acquired neonatal pneumonia, analyze the reason, and discuss the intervention strategy. Methods Retrospective analysis was performed on the bacterial cultures of sputum specimens and drug sensibility results of 60 newborns with hospital acquired neonatal pneumonia in our hospital＇ s neonatal intensive care unit （NICU） from June 2012 to June 2013. The distribution of pathogens was investigated, the causes of hospital infection neonatal pneumonia were analyzed, and corresponding care strate- gies were adopted. Results 72 Pathogenic strains were isolated from 60 specimens, including 20 gram-positive strains （27.8%） in which Staphylococcus aureus, Streptococcus viridans and Epidermis staphylococcus were the main pathogens. There were 52 Gram-negative strains （72.2%）, with Klebsiellapneumoniae, Escherichia coli and Acinetobacter baumannii being the main pathogens. 6 strains of Staphylococcus aureus （MRSA） were methicillin re- sistant （50%） ; 13 strains of Klebsiella pneumoniae were multiple drug-resistant （56.5%） ; 6 strains of Escherichi- a coli were multiple drug-resistant （46.2%） ; 4 strains of Acinetobacter baumannii were multiple drug-resistant （66.7%）; 2 strains of Pseudomonas aeruginosa were multiple drug-resistant （50%）. All the Stenotrophomonas maltophilia and Stenotrophomonas maltophilia strains were multiple drug-resistant bacteria. Conclusion Gram- negative bacteria are the main pathogenic bacteria of hospital acquired neonatal pneumonia, with a high rate of mul- tidrug resistant strains. Through effective intervention measurements, the morbidity of hospital acquired neonatal pneumonia can be reduced.