小儿呼吸道感染金黄色葡萄球菌的耐药性分析  

Analysis of drug resistance of Staphylococcus aureus from pediatric respiratory infection patients

作　　者：李仕伟[1] 傅雷[1] 李萍[1] 王磊[1] 

机构地区：[1]南京医科大学附属南京医院(南京临床核医学中心),江苏南京210006

出　　处：《现代预防医学》2016年第6期1023-1026,共4页Modern Preventive Medicine

摘　　要：目的调查金黄色葡萄球菌在小儿呼吸道标本中的检出情况及耐药特点,为临床治疗提供依据。方法对小儿科2011-2014年4 876份呼吸道标本检出的金黄色葡萄球菌耐药性进行回顾性分析总结;采用法国生物梅里埃公司VITEK-2全自动微生物鉴定仪进行菌株鉴定,K-B法进行药敏试验,结果判断参照美国临床实验室标准化研究所标准;采用WHONET软件进行统计分析。结果共检出448株金黄色葡萄球菌,其中检出耐甲氧西林金黄色葡萄球菌(MRSA)42株,占9.4%。耐药率较高的抗菌药物主要是青霉素G(92.9%)、红霉素(58.0%)、克林霉素(55.1%)、四环素(19.9%)等;MRSA的耐药情况较甲氧西林敏感的金黄色葡萄球菌(MSSA)明显严重,对庆大霉素、环丙沙星、左旋氧氟沙星、莫西沙星、红霉素、克林霉素等耐药性差异有统计学意义(P<0.05)。结论小儿呼吸道标本检出的金黄色葡萄球菌以MSSA为主,对大部分的抗菌药物保持较好的敏感性,但其耐药性有上升趋势不容轻视。Objective This work aimed to investigate the current status of the detection and antibiotic resistance of Staphylococcus aureus（ S. aureus） in the respiratory tract samples from inpatients of pediatric department,so as to provide references for clinical treatment. Methods Retrospective review was performed to analyze the drug resistance of S. aureus isolated from 4876 respiratory tract specimens from 2011 to 2014,then the strains were identified by using VITEK- 2 automatic microorganism identification system of Bio Mérieux,France. The drug susceptibility test was performed with K- B method. The results were interpreted by referring to the criteria of Clinical Laboratory Standard Institute. Results A total of 448 strains of S. aureus were isolated from the respiratory tract specimens. The detection rate of methicillin- resistant S. aureus（ MRSA）was 9. 4%（ 42 /448）. The drug resistance rate of S. aureus was 92. 9% to penicillin G,58. 0% to erythromycin,55. 1% to clindamycin,and 19. 9% to tetracycline. MRSA was more resistant to 17 kinds of antibiotics than methicillin sensitive S.aureus（ MSSA）,and the difference between MRSA and MSSA in the resistance to gentamycin,ciprofloxacin,ofloxacin,moxifloxacin,erythromycin and clindamycin were statistical significant（ P〈0. 05）. Conclusion Most S. aureus isolates were MSSA which were susceptible to most antibiotics currently in use. However,the detection rate of MRSA was increasing and the situation of drug resistance was getting more serious.

关 键 词：呼吸道感染 金黄色葡萄球菌 耐药性 小儿 

分 类 号：R378[医药卫生—病原生物学]