483例儿童扁桃体腺样体肥大分离菌的分布和药敏特征  

Analysis of the Distribution of Pathogenic Bacterium and its Drug Resistance Characteristics in 483 Samples from Tonsil Adenoidectomy in Children

作　　者：黄莲芬 谢永强[1,2] 邓秋连 钟华敏[1,2] 刘海英 周珍文[1,2] 

机构地区：[1]广州市妇女儿童医疗中心 [2]广州市儿童医院检验科,广东广州510120

出　　处：《现代生物医学进展》2015年第23期4492-4497,共6页Progress in Modern Biomedicine

基　　金：广州市卫生局课题(201102A212013;2013A011040022)

摘　　要：目的:分析儿童手术切除的扁桃体腺样体分离菌的分布及药敏特征,为其临床预防和治疗提供指导。方法:将483例扁桃体腺样体进行细菌培养,分析潜在致病菌组成及其药敏特征。结果:扁桃体和腺样体的细菌培养阳性率分别为66.43%和52.88%,主要病原菌及其分离率分别为金黄色葡萄球菌(20.71%)、流感嗜血杆菌(15.11%)、肺炎链球菌(10.97%)、A群链球菌(6.42%),金黄色葡萄球菌对青霉素的耐药率达82%,21%菌株为MRSA,流感嗜血杆菌β-内酰酶检测阳性率为30.92%,复方新诺明和氨苄西林耐药率较高,分别为50.69%和30.14%,肺炎链球菌对青霉素耐药率为32.08%,红霉素、四环素、复方新诺明耐药率高,分别为81.13%、79.25%和69.81%,A群链球菌对青霉素仍然100%敏感,红霉素、克林霉素、四环素的耐药率高,分别为83.87%、77.42%、58.06%。结论:扁桃体和腺样体主要分离菌有金黄色葡萄球菌、流感嗜血杆菌、肺炎链球菌、A群链球菌,不同检出菌的耐药性差异明显,临床可根据常见检出分离菌的分布及药敏特征预防和治疗感染。Objective： To explore the distribution of isolated bacteria and its drug susceptibility feature in culture of tissues from tonsil adenoidectomy in children, and provide instructions for the clinical prevention and treatment. Methods： 483 cases of adenoid tonsil samples were collected for bacterial culture, the main isolated bacteria and drug susceptibility feature were analyzed. Results： The positive rate of pathogenic bacteria was 66.43% and 52.88% for tonsil and adenoid samples respectively. There were four main bacteria,including staphylococcus aureus, haemophilus influenze, streptococcus pneumoniae, group A streptococcus, which accounted for20.71%, 15.11%, 10.97%, 6.42% respectively. S. aureus had a resistant rate of 82% to penicillin, of which 21% isolates were MRSA.While for h. influenzae, the positive rate of beta-lactamase was 30.92%, with a high resistant rate of 50.69% and 30.14% to trimethoprim-sulfamethoxazole and ampicillin respectively. Streptococcus pneumoniae had a resistant rate of 32.08% to penicillin, with a high resistant rate of 81.13%, 79.25% and 69.81% to erythromycin, tetracycline, trimethoprim-sulfamethoxazole respectively. For group A streptococcus, no resistance to penicillin was detected, with a high resistant rate of 83.87%, 77.42% and 58.06% for erythromycin,clindamycin, tetracycline. Conclusions： The main isolated potential pathogenic bacteria included s. aureus, h. influenzae, streptococcus pneumoniae, group A streptococcus. There were obvious differences of the drug resistance among them, which could afford good instructions for its clinical prevention and treatment of pediatric tonsil and adenoid infection.

关 键 词：扁桃体 腺样体 分离菌 耐药 

分 类 号：R446.5[医药卫生—诊断学]