儿童金黄色葡萄球菌感染462株临床分布特点及耐药趋势分析  

Clinical distribution characteristics and drug resistance trend in 462 strains of Staphylococcus aureus isolated from pediatric patients

作　　者：晏霞[1] 于会娜[1] Yan Xia;Yu Huina(Department of Pediatrics,Jingzhou Central Hospital,Jingzhou,Hubei 434000,China)

机构地区：[1]荆州市中心医院儿科,湖北省434000

出　　处：《中国基层医药》2020年第24期3035-3038,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析儿童金黄色葡萄球菌感染的临床分布特点及耐药性,为合理使用抗菌药物提供临床依据。方法收集荆州市中心医院2016-2019年住院患儿送检的痰标本中分离出的金黄色葡萄球菌462株,分析金黄色葡萄球菌感染的临床分布特点及对各种抗菌药物的耐药情况。结果462株金黄色葡萄球菌感染中,男性285株,女性177株;金黄色葡萄球菌主要感染1岁以下患儿(χ^2=73.163,P<0.001),季节以冬春季节为主(χ^2=27.656,P<0.001);共检出462株金黄色葡萄球菌,其中甲氧西林敏感金黄色葡萄球菌(MSSA)363株,占78.6%,耐甲氧西林金黄色葡萄球菌(MRSA)99株,占21.4%,MSSA和MRSA对万古霉素、替加环素、替考拉宁、利福平、利奈唑胺、奎奴普丁-达福普汀和呋喃妥因均100.0%敏感;MSSA对左氧氟沙星、庆大霉素、复方磺胺甲噁唑、苯唑西林、莫西沙星、环丙沙星、四环素的敏感性分别为100.0%、95.9%、91.7%、72.2%、96.7%、92.6%、90.0%;MRSA对左氧氟沙星、庆大霉素、复方磺胺甲噁唑、苯唑西林、利福平、莫西沙星、环丙沙星、四环素的敏感性分别为91.9%、82.8%、80.8%、57.6%、90.9%、77.8%、76.8%,提示MRSA的耐药率较MSSA高;MSSA耐药率较高的抗菌药物主要是青霉素G(91.2%)、红霉素(61.7%)、克林霉素(50.1%),MRSA对青霉素G、红霉素、克林霉素均100.0%耐药。结论儿童金黄色葡萄球菌感染的形势严峻,且小儿呼吸道感染的标本中检出的金黄色葡萄球菌以MSSA为主,对大部分的抗菌药物的敏感性较好,MRSA和MSSA对各种抗菌药物的耐药性差异明显,应合理使用抗菌素,并加强院内感染控制,防止及减少MRSA的产生。Objective:To analyze the clinical distribution characteristics and drug resistance of Staphylococcus aureus infection and provide clinical basis for rational use of antibacterial drugs.Methods:From 2016 to 2019,462 strains of Staphylococcus aureus were collected from sputum specimens of hospitalized children in Jingzhou Central Hospital.The clinical distribution characteristics of Staphylococcus aureus infection and drug resistance of various antibacterial drugs were analyzed.Results:Among 462 strains of Staphylococcus aureus infection,285 strains were male,accounting for 61.7%,177 strains were female,accounting for 38.3%.There was no statisticall significant difference between male and female children with Staphylococcus aureus pneumonia(χ^2=0.762,P=0.383).Staphylococcus aureus mainly infected children under 1 year old(χ^2=73.163,P<0.001),and the seasonal distribution was mainly in winter and spring(χ^2=27.656,P<0.001).A total of 462 strains of Staphylococcus aureus were detected,of which 363 strains(78.6%)were methicillin-sensitive Staphylococcus aureus(MSSA),and 99 strains(21.4%)were methicillin-resistant Staphylococcus aureus(MRSA).MSSA and MRSA were 100%sensitive to vancomycin,tigecycline,teicoplanin,rifampicin,linezolid,quinoprotein-daffodil and nitrofurantoin.The sensitivity of MSSA to levofloxacin,gentamicin,compound sulfamethoxazole,oxacillin,moxifloxacin,ciprofloxacin and tetracycline were 100.0%,95.9%,91.7%,72.2%,96.7%,92.6% and 90.0%,respectively.The sensitivity of MRSA to levofloxacin,gentamicin,compound sulfamethoxazole,oxacillin,rifampicin,moxifloxacin,ciprofloxacin and tetracycline were 91.9%,82.8%,80.8%,57.6%,90.9%,77.8% and 76.8%,respectively,and it suggested that the drug resistance rate of MRSA was higher than MSSA,and there was statistically significant difference.The antibiotics with high MSSA resistance rate were penicillin G(91.2%),erythromycin(61.7%),clindamycin(50.1%),MRSA was 100.0% resistant to penicillin G,erythromycin and clindamycin.Conclusion:The situation of clinical infection

关 键 词：金黄色葡萄球菌 抗菌药 抗药性 呼吸道感染 儿童 

分 类 号：R446.5[医药卫生—诊断学] R725.1[医药卫生—临床医学]