摘要
目的探讨和分析金黄色葡萄球菌在儿科呼吸道感染患者中的分离与耐药性变化，为指导临床用药控制感染提供依据。方法采集2013年1月～2014年12月两年儿科（包括新生儿科）呼吸道感染患者痰液标本共5413例，应用 Mi-croScan-As4微生物自动鉴定分析仪对分离后的菌株进行鉴定和药物敏感试验，用 Whonet5.6软件进行统计分析。结果从儿科呼吸道感染患者标本中共分离出各种病原菌29种1540株。其中金黄色葡萄球菌（S.aureus，SAU）336株（21.82％，336／1540），超过总病原菌的1／5，在儿科呼吸道感染分离率占6.21％，显著高于其它病原菌分离率（除流感嗜血杆菌5％外，其余均＜5％）。在所有检出 SAU中耐甲氧西林金黄色葡萄球菌（MRSA）59株（17.56％，59／336），可以看出 SAU在儿科呼吸道感染患者中占据首要位置。SAU对万古霉素、利奈唑胺、达托霉素、奎奴普丁这4种抗菌药物耐药率为0，对其它抗菌药物呈现不同程度耐药性；MRSA对青霉素、氨苄西林、苯唑西林、氨苄西林／舒巴坦、阿莫西林／克拉维酸、头孢唑林、头孢曲松耐药率为100％，对红霉素、克林霉素耐药率超过50％，对其它抗菌药物耐药性呈低耐药性。结论儿童呼吸道感染 SAU较多，尤其 MRSA多重耐药现象严重。应加强对金黄色葡萄球菌耐药性监测，根据药敏试验结果进行个体化、合理化选用抗菌药物，有效控制和减少耐药菌株产生。
Objective Discuss and analyze Staphylococcusaureus in isolation and drug resistance in patients with pediatric re-spiratory infection,providing guidelines for clinical treatment on the control of infection.Approaches collect 5 413 cases of respiratory tract infection from Jan.2013 to Dec.2014 in patients （including pediatrics neonatology）with sputum specimens, applying MicroScan-As4 automated Microbes Identification analyzer to identify and test drug sensitiveness of the separated strains,using Whonet 5.6 for statistical analysis.Results 1 540 strains of 29 different pathogenic bacteria were isolate from pediatric patients with respiratory tract infection,among which there were 336 strains （21.82%,336/1540）of Staphylococ-cus aureus （SAU,S.aureus）,more than 1/5 of the total of pathogenic bacteria.And the isolation rate of pediatric respiratory tract infection accounted for 6.2 1%,significantly higher than that of other pathogenic bacteria isolation rate （with the excep-tion of Haemophilus influenzae〉5%,the rest all〉5%）.In all detected SAU,methicillin-resistant Staphylococcus aureus （MRSA）occpied 59 strains （17.56%,59/336）,which indicated that SAU played a leading place in patients with pediatric respiratory infection.The antimicrobial drug resistance rate of SAU against vancomycin,Nai thiazoleamine,daptomycin,and Quinupristin was 0,whereas to other antibiotics it showed different degrees of resistance.The drug resistance rate of MRSA to penicillin and ampicillin,oxacillin,ampicillin/sulbactam,amoxicillin/clavulanic acid and cefazolin,ceftriaxone was 100%,to erythromycin,clindamycin over 50%,to other antimicrobial resistance in low resistance.Conclusion There were more SAU in children with respiratory infection;especially MRSA bears multi drug resistance.Therefore,the monitoring of drug resist-ance of Staphylococcus aureus should be strengthened,and antimicrobial drugs should be rationally chosen according to the results of drug sensitive test for individuals,so that resistant strains can be under effective control and kept being reduced from emergence.
出处
《现代检验医学杂志》
CAS
2016年第3期150-152,155,共4页
Journal of Modern Laboratory Medicine
关键词
金黄色葡萄球菌
耐甲氧西林金黄色葡萄球菌
儿科
呼吸道感染
耐药性
Staphylococcus aureus
methicillin-resistant Staphylococcus aureus
pediatrics
respiratory infections
drug-resist-ance
