住院患儿MSSA与MRSA的分布特点及耐药性  

Distribution and antimicrobial resistance of methicillin-sensitive Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in hospitalized children

作　　者：陆一[1] 董亮[1] 杨佶[1] 张秀红[1] 耿先龙[1] 

机构地区：[1]南京医科大学附属无锡人民医院,江苏无锡214023

出　　处：《中国感染控制杂志》2017年第7期596-599,共4页Chinese Journal of Infection Control

基　　金：国家自然科学基金(81400054);无锡市卫生局妇幼保健项目(FYKY 201405)

摘　　要：目的比较住院患儿甲氧西林敏感金黄色葡萄球菌(MSSA)与耐甲氧西林金黄色葡萄球菌(MRSA)的分布及耐药特点,为临床经验治疗提供依据。方法回顾性分析2011—2015年某院住院患儿分离的金黄色葡萄球菌及其临床资料,比较MSSA与MRSA的分布及耐药特点。结果共分离金黄色葡萄球菌919株,其中MSSA632株(68.77%),MRSA 287株(31.23%)。MSSA与MRSA感染患儿中29d^1岁婴儿组所占比率最高,分别为65.03%、64.11%。MSSA和MRSA标本主要来自痰(80.38%、79.09%)。MSSA和MRSA主要分布科室均为儿童呼吸科(50.73%、45.89%)和儿童神经内科(22.98%、26.84%)。MSSA对除青霉素和红霉素外的抗菌药物耐药率均<20.00%;MRSA对青霉素、苯唑西林、红霉素及克林霉素的耐药率均>40.00%;MRSA对四环素、红霉素、克林霉素、左氧氟沙星、环丙沙星、莫西沙星、呋喃妥因及利福平的耐药率均高于MSSA。结论住院患儿分离的金黄色葡萄球菌以MSSA为主,1岁以内婴儿为主要分离人群;呼吸道标本来源的MSSA和MRSA主要分布科室相似,MRSA的耐药率普遍高于MSSA。ObjectiveTo compare distribution and antimicrobial resistance of methicillinsensitive Staphylococcus aureus（MSSA） and methicillinresistant Staphylococcus aureus（MRSA） in hospitalized children, and provide reference for empirical use of antimicrobial agents. MethodsIsolation and clinical data of Staphylococcus aureus（ S. aureus） from hospitalized children in a hospital during 2011-2015 were analyzed retrospectively, distribution and antimicrobial resistance between MSSA and MRSA were compared.ResultsA total of 919 strains of S. aureus were isolated, 632（68.77% ） of which were MSSA, 287（31.23%）were MRSA. 65.03% of MSSA infection and 64.11% of MRSA infection were in children aged 29 day1 year old. 80.38% of MSSA and 79.09% of MRSA were isolated from sputum specimen. MSSA and MRSA were mainly distributed in department of pediatric respiratory medicine（50.73%, 45.89% respectively） and department of pediatric neurology（22.98%, 26.84% respectively）. Resistance rates of MSSA to antimicrobial agents were〈20.00% except penicillin and erythromycin; resistance rates of MRSA to penicillin, oxacillin, erythromycin, and clindamycin were all〉40.00%; resistance rates of MRSA to tetracycline, erythromycin, clindamycin, levofloxacin, ciprofloxacin, moxifloxacin, nitrofurantoin, and rifampin were all higher than MSSA. ConclusionMSSA is main S. aureus isolated from hospitalized children, infants under 1 year of age are the main population, the main distribution departments of MSSA and MRSA from respiratory tract specimen are similar, antimicrobial resistance of MRSA is generally higher than that of MSSA.

关 键 词：住院患儿 金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 抗药性 微生物 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]