Distribution and Drug Resistance of Pathogens in Neonates with Lower Respiratory Tract Infection_West China Medical Journal

Authors：

 KUANGLing-han , WANGJia-min , ZHOUWei ,  JIANGYong-mei

Clinical Laboratory Department, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

JIANGYong-mei, Email: jiangyongmei-1@163.com

Keywords：

Lower respiratory tract infection; Pathogen; Drug resistance; Neonate

DOI：

10.7507/1002-0179.20140126

Video：

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Objective To investigate the distribution and drug resistance of pathogens in neonates with lower respiratory tract infection, and provide evidence for clinical rational antibiotic use. Methods A retrospective analysis on 998 strains isolated from 5 486 sputum samples during January 1, 2009 to December 31, 2012 collected from hospitalized neonates was performed. Results Of the 998 isolated strains, the common pathogens were Klebsiella pneumoniae (23.1%), Escherichia coli (E. coli) (21.2%), Staphylococcus aureus (19.4%), and Enterobacter cloacae (8.4%). Klebsiella pneumonia, E. coli and Enterobacter cloacae were generally resistant to penicillin, but enzyme inhibitors could reduce the resistance rate. A large proportion of Klebsiella pneumonia was resistant to the third generation cephalosporins (78.4%), while E. coli and Enterobacter cloacae had a lower resistance rate (46.7% and 46.5%, respectively). There were 7 strains (3.0%) of Klebsiella pneumoniae and 1 (1.2%) strain of Enterobacter cloacae resistant to imipenem. Twenty-three strains (13.6%) of Klebsiella pneumoniae, 1 strain (0.7%) of E.coli and 1 strain (2.5%) of Enterobacter cloacae were resistant to ertapenem. A total of 97.0% of Staphylococcus aureus was resistant to penicillin, but only 11.0% was resistant to oxacillin, and all the isolates were sensitive to vancomycin. Conclusion Gram negative bacteria are the common pathogens in the hospitalized neonates in our hospital. Klebsiella pneumonia, E. coli and Staphylococcus aureus are the common pathogens. The common pathogens show a high resistant level to antibiotics. Clinicians should evaluate the potential pathogens of infections based on the results presented in our study, in order to select antibiotics rationally when treating infections.

Citation： KUANGLing-han, WANGJia-min, ZHOUWei, JIANGYong-mei. Distribution and Drug Resistance of Pathogens in Neonates with Lower Respiratory Tract Infection. West China Medical Journal, 2014, 29(3): 417-420. doi: 10.7507/1002-0179.20140126 Copy

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1. Ralpha DF, Cherry JD, Demmler-Harrison GJ, et al. Feigin & Cherry's textbook of pediatric infectious diseases[M]. 6th ed. Philadelphia:Saunders Elsevier, 2009:269-342.
2. 叶应妩, 王毓三, 中华人民共和国卫生部医政司. 全国临床检验操作规程[M]. 2版. 南京:东南大学出版社, 1997:754-869.
3. Rudan L, Boschi-Pinto C, Biloglav Z, et al. Epidenmiology and etiology of childhood pneumonia[J]. Bull World Health Organ, 2008, 86(5):408-416.
4. Centers for Disease Control and Prevention. Staphylococcus aureus with reduced susceptibility to vancomycin-Illinois, 1999[J]. MMWR Morb Mortal Wkly Rep, 2000, 48(51-52):1165-1167.
5. 张金峰. 2005-2010年小儿下呼吸道感染病原菌分布及耐药性分析[J]. 中华医院感染学杂志, 2012, 22(8):1745-1747.
6. 李晓瑜, 陈东平, 庄思齐, 等. 26例新生儿肺炎克雷伯菌感染的临床特征及药敏分析[J]. 中国当代儿科杂志, 2003, 5(5):461-463.
7. 周清德, 缪竞智, 张秀珍. 产ESBL肺炎克雷伯菌医院感染分子流行病学研究[J]. 中华医院感染学杂志, 2000, 10(1):10-12.
8. 林庆安, 罗文侗, 修清玉, 等. 超广谱β-内酰胺酶肺炎克雷伯菌大肠埃希菌耐药监测[J]. 中华检验医学杂志, 2001, 24(4):10.
9. Centers for Disease Control and Prevention. Staphylococcus aureus resistant to vancomycin-United States, 2002[J]. MMWR Morb Mortal Wkly Rep, 2002, 51(26):565-567.
10. Centers for Disease Control and Prevention. Brief report:vancomycin resistant Staphylococcus aureus New York, 2004[J]. MorbMortal Wkly Rep, 2004, 53(15):322-323.
11. 李家泰, Weinstein A, 杨敏, 等. 中国细菌耐药监测研究[J]. 中华医学杂志, 2001, 81(1):11-19.
12. Böswald M, Döbig C, Kändler C, et al. Pharmacokinetic and clinical evaluation of serious infections in premature and newborn infants under therapy with imipenem/cilastatin[J]. Infection, 27(4/5):299-304.
13. 汪复. 产β-内酰胺酶耐药菌感染的防治策略[J]. 中华传染病杂志, 2000, 18(3):4-5.
14. 聂川, 张永, 罗先琼, 等. 新生儿病房阴沟肠杆菌感染及药敏结果分析[J]. 临床儿科杂志, 2011, 29(9):825-828.

West China Medical Journal

Distribution and Drug Resistance of Pathogens in Neonates with Lower Respiratory Tract Infection

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