儿童皮肤软组织感染金黄色葡萄球菌的临床特点与耐药状况  

Clinical Characteristics and Antibiotic Resistance of Staphylococcus Aureus from Skin and Soft Tissue Infections in Children

作　　者：王群[1] 杨永弘[2] 耿文静[2] 吴德静[2] 袁林[2] 俞桑洁[2] 沈叙庄[2] 

机构地区：[1]桂林医学院附属医院儿科,广西桂林541001 [2]首都医科大学附属北京儿童医院微生物免疫室,北京100045

出　　处：《实用儿科临床杂志》2009年第22期1711-1713,共3页Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金项目资助(30872789)

摘　　要：目的研究北京地区儿童皮肤软组织感染(SSTIs)金黄色葡萄球菌(SAU)的临床特点与耐药状况。方法对2008年9月-2009年4月北京儿童医院外科门诊922例SSTIs患儿进行现场调查,记录患儿的性别、年龄、住址、感染发生部位、临床诊断、抗生素使用情况和诱发因素等,采集脓液标本行SAU分离培养,菌株鉴定采用乳胶凝集试验,琼脂倍比稀释法测定抗生素对SAU的最小抑菌浓度(M IC),用WHONET 5.4统计软件分析药物敏感性试验结果。结果分离出SAU 298株,分离率为32.3%,分离率较高的部位是甲沟和脐部;SAU感染男女比例为1.87 1.00;好发年龄为11 d～3岁,占总数的57.7%;脓肿最常见(31.54%),其中以颈部最多(39.4%);SAU对青霉素、红霉素、克林霉素、磺胺甲唑/甲氧苄啶的耐药率分别为85.2%、71.1%、63.7%、55.6%,M IC50分别为0.50、256.00、128.00、8.00,M IC90分别为16、>256、>256、32;大多数β-内酰胺类抗生素的耐药率<15%,M IC50、M IC90处于较低水平;未发现对万古霉素耐药或中介的菌株。结论SAU引起的儿童SSTIs男多于女,好发于婴幼儿,脓肿最多见;SAU对青霉素、红霉素、克林霉素和磺胺甲唑/甲氧苄啶耐药率较高,对大多数β-内酰胺类抗生素有较高的敏感性。Objective To investigate the clinical characteristics and antibiotic resistance of staphylococcus aureus（SAU） from skin and soft tissue infections（SSTIs） in children. Methods A total of 922 children with SSTIs in Beijing children＇s hospital from Sep. 2008 to Apr. 2009 were investigated. The informations of the patients such as sex, age, address, the position of infection, clinical diagnosis, protopathy, the condition of using antibiotics and causative factors were recorded. The SAU strains were isolated from liquor puffs, and the strains were identi- fied by using latex agglutination test. The minimal inhibitory concentrations （MIC） of antibiotics against SAU were determined by means of agar dilution method according to the guidelines of the clinical and laboratory standards institute, the data were analyzed by using WHONET 5.4 software. Resulls Two hundred and ninety - eight strains of SAU were separated and the separation rate was 32.3% , as a result the most common locus were nail groove and omphaloidean. The incidence rate of SSTIs in boys was higher than that in girls, as the rate was 1.87 ： 1.00,and the most common age with SSTIs was 11 d - 3 years, which accounted for 57.7%. The most common type of SSTIs was abscess （31.54% ） , especially abscess from neck （39.4%）. The resistance rates of SAU to Penicillin, Erythromycin, Clindamycin, Sulfamethoxazole/ Trimethoprim were 85.2% ,71.1% ,63.7% and 55.6% , respectively, and the MICs0 and MICgo of them were 0. 50 , 256. 00 ,128 . 00 , 8. 00 and 16, 〉 256, 〉 256,32,respectively. The resistance rate of SAU to most of the β-lactam antibiotics were below 15% ,and the MIC50 and MIC90 of them were on the low level. No strain was found to be resistant to vaneomyein. Conclusions The incidence rate of SSTIs caused by SAU in boys were higher than that in girls, and young children were the predilection age of onset, in which the most common type was abscess. SAU had strong resistance to Penicillin, Erythromyein, Clindamyein and Sulfamethoxazole/

关 键 词：金黄色葡萄球菌 皮肤软组织感染 耐药 儿童 

分 类 号：R726.5[医药卫生—儿科] R446.5[医药卫生—临床医学]