上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 专题报道（新生儿基础与临床研究） • 上一篇    下一篇

新生儿耐药菌谱及治疗进展

唐 俊，张拥军   

  1. 上海交通大学 医学院附属新华医院新生儿科， 上海 200092
  • 出版日期:2013-07-28 发布日期:2013-08-22
  • 通讯作者: 张拥军, 电子信箱: dryongjunzhang@163.com。
  • 作者简介:唐俊（1986—），女，硕士生; 电子信箱: tangjun6313@hotmail.com。

Epidemiology and advances in management of antibiotic resistance in neonates

TANG Jun, ZHANG Yong-jun   

  1. Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2013-07-28 Published:2013-08-22

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摘要：

重症监护室的新生儿是医源性感染的高风险人群，随着围产医学及新生儿重症监护技术的发展，早产儿的存活率逐年提高。但由于住院时间长，早产儿发生院内感染的风险随之升高。抗生素的经验治疗导致大量多重耐药菌的产生。多重耐药菌主要为革兰阳性菌，万古霉素是治疗此类菌的首选药物，但耐万古霉素细菌的定植感染率日益升高，其潜在威胁还未明确。最近，多重耐药革兰阴性菌包括耐碳青霉素类菌种的快速传播日益严重，治疗可选的药物品种受到限制。黏菌素及替吉环素等临床非一线药物的使用有所增加，但此类药物应用于新生儿的严重感染仍需谨慎管理。

关键词: 耐药菌, 新生儿, 治疗进展

Abstract:

Nosocomial infection is common in the neonatal intensive care unit. The rapid development of perinatal medicine and medical technology in neonatal intensive care unit has improved the survival of premature infants. With the longer duration of hospitalization, premature infants are exposed to the threat of nosocomial infection. Empiric antimicrobial therapy has resulted in an increase in the proportion of antibiotic-resistant organisms. Multi-resistance is mainly found in Gram-positive bacteria, and Vancomycin is the main treatment. However, the number of Vancomycin-resistant bacteria is increasing, and the potential threat has been a concern. Gram-negative bacteria, including carbapenem-resistant strains, is much more ominous, and the treatment options are extremely limited. Non-first-line drugs such as Colistin and Tigecycline are more frequently used, while intensive management should be done in application of these drugs on neonates for severe infection.

Key words: antibiotic-resistant organisms, neonates, advances in management