一家三级护理医院新生儿败血症分离菌的细菌学特征和抗生素分布模式

K. U. Devi, B. Manjula, P. Kamala
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摘要

目的确定新生儿败血症分离物的微生物特征及其抗生素谱模式。研究方法本研究于 2022 年 10 月至 2023 年 1 月 15 日进行。新生儿重症监护室共收到 663 份血液样本,这些样本在维萨卡帕特南安得拉医学院微生物学系进行了处理。根据 CLSI 指南,采用传统方法对微生物进行鉴定,并采用柯比鲍尔盘扩散法进行抗生素药敏试验。结果:663 份样本中有 200 份(30.16%)培养呈阳性,其中男性多于女性,为 103 份(51.5%)。在培养呈阳性的样本中,最主要的分离菌株是克雷伯菌 106 株(53%),其次是假单胞菌 28 株(14%)、大肠杆菌 28 株(14%)、醋杆菌 24 株(12%)、MRSA 11 株(0.05%)、MSSA 3 株(0.015%)。在抗菌谱方面,克雷伯菌和大肠埃希菌分别对青霉素类+β-内酰胺酶抑制剂(83%)、氟喹诺酮类(75%)和氨基糖苷类(75%)最敏感。假单胞菌和不动杆菌对青霉素类+beta内酰胺酶抑制剂(100%)和氨基糖苷类(72%)敏感。革兰氏阳性菌大多对万古霉素、利奈唑胺、氨基糖苷类(MRSA)和头孢西丁(MSSA)敏感。革兰氏阴性菌普遍对第三代头孢菌素(77.77%)产生耐药性。结论革兰氏阴性菌是新生儿败血症最常见的病因,而克雷伯氏菌是最主要的病原体。这些革兰氏阴性菌对头孢菌素类产生耐药性。抗生素图谱有助于指导抗菌治疗和抗生素耐药性的产生,因为这是导致经验性治疗无效的常见问题。
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BACTERIOLOGICAL PROFILE AND ANTIBIOGRAM PATTERN IN ISOLATES FROM NEONATAL SEPSIS IN A TERTIARY CARE HOSPITAL
Objective: To determine the microbiological profile and their Antibiogram pattern in isolates from neonatal sepsis. Methods: This study was conducted from October 2022 to January 15th 2023. Total 663 blood samples received from NICU, which were processed in the department of microbiology Andhra Medical College, Visakhapatnam. Organisms were identified by conventional methods and an antibiotic susceptibility test was done by Kirby Bauer disc diffusion method as per CLSI guidelines. Results: Out of 663 samples 200 (30.16%) are culture positives, in which males are more affected than females, that is 103 (51.5%). Among the culture positives, the most predominant isolate was klebsiella species 106 (53%) followed by pseudomonas 28 (14%) Escherichia coli 28 (14%) Acinetobacter 24 (12%), MRSA 11 (0.05%), MSSA 3(0.015%). Regarding its antibiogram, klebsiella species and Escherichia coli were most sensitive to penicillins+beta lactamase inhibitors (83%), fluroquinolones (75%) and aminoglycosides (75%), respectively. Pseudomonas, Acinetobacter was sensitive to penicillins+betalactamase inhibitors (100%) and aminoglycosides (72%). Gram-positive organisms were mostly sensitive to vancomycin, linezolid, aminoglycosides (MRSA) and cefoxitin (MSSA). There was widespread resistance to third-generation cephalosporins (77.77%) among gram-negative organisms. Conclusion: Gram negative bacteria are the most common cause of neonatal sepsis and klebsiella species are the predominant pathogens. These gram negative bacteria were resistant to cephalosporins. Antibiogram helps as a guide to antimicrobial therapy and resistance to antibiotics, as it is the common problem that causes ineffectiveness of empirical treatment.
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