内蒙古医科大学附属医院儿童肠道可培养拟杆菌耐药性研究  

Study on antibiotic resistance of culturable Bacteroides from the intestinal tract of children in the Affiliated Hospital of Inner Mongolia Medical University

作　　者：侯美玲 王继春[1] 王俊瑞[2] 郑文琪[2] 刘德艳 Hou Meiling;Wang Jichun;Wang Junrui;Zheng Wenqi;Liu Deyan(Department of Pediatrics,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050;Department of Clinical Laboratory,the Affiliated Hospital of Inner Mongolian Medical University,Hohhot 010050)

机构地区：[1]内蒙古医科大学附属医院儿科,呼和浩特010050 [2]内蒙古医科大学附属医院检验科,呼和浩特010050

出　　处：《中国抗生素杂志》2024年第4期469-475,共7页Chinese Journal of Antibiotics

基　　金：内蒙古医科大学附属医院重点实验室开放基金项目(No.2022NYFY SYS007);内蒙古自治区卫生健康科技计划项目(No.202201305)。

摘　　要：目的探究呼和浩特地区儿童肠道可培养拟杆菌对抗菌药物的耐药性。方法收集2021年03月—2022年09月期间我院儿科住院儿童的粪便标本及临床资料,采用VITEK-2 Compact全自动微生物鉴定系统及厌氧菌及棒状杆菌(ANC)鉴定卡、MALDI-TOFMS质谱仪鉴定、分离拟杆菌,采用琼脂稀释法测定拟杆菌对多种抗菌药物的敏感性。结果本研究共收集219株拟杆菌分离株,对多种抗菌药物有较高的耐药性,其对青霉素、阿莫西林、克林霉素、替卡西林和哌拉西林高度耐药,耐药率分别为:100%、97.7%、97.3%、70.3%和68.0%;对头孢替坦、头孢西丁、阿莫西林/克拉维酸和亚胺培南中度耐药,耐药率分别为:50.2%、36.1%、17.8%和12.3%;对甲硝唑、替卡西林/克拉维酸、哌拉西林/他唑巴坦、氯霉素轻度耐药,耐药率分别为:9.1%、5.5%、4.6%和0.9%。结论我地区儿童肠道可培养拟杆菌对多种常用抗菌药物耐药性较高,尤以青霉素、阿莫西林、克林霉素、替卡西林和哌拉西林为甚,其中,脆弱拟杆菌对头孢替坦、头孢西丁和亚胺培南的耐药率高于其他拟杆菌。既往有广谱抗生素用药史的儿童中分离获得菌对哌拉西林、头孢替坦、替卡西林、头孢西丁和亚胺培南的耐药率高于无相关用药史的儿童来源菌,且从年长儿肠道分离的拟杆菌对头孢西丁、亚胺培南耐药性高于低龄儿童。我国儿童拟杆菌的耐药性可能被严重低估,应加强不同地区针对儿童拟杆菌的抗微生物药物敏感性试验系统性监测。Objective This study aimed to explore the antibiotic resistance of culturable Bacteroides in children’s intestinal tracts in Hohhot.Methods The faecal samples and clinical data of pediatric patients were collected in the Affiliated Hospital of Inner Mongolia Medical University from March 2021 to September 2022.Both the VITEK-2 compact automated microbiology system with anaerobes and coryne bacterium(ANC)cards and MALDI-TOF MS were used to identify and isolate the Bacteroides.The susceptibility of Bacteroides to multiple antibiotics was determined using the agar dilution method.Results A total of 219 Bacteroides isolates were collected in this study,which showed high resistance to a variety of antibiotics.They were highly resistant to penicillin,amoxicillin,clindamycin,ticacillin and piperacillin,with resistance rates of 100%,97.7%,97.3%,70.3%and 68.0%,respectively.Cefotetan,cefoxitin,amoxicillin+clavulanate and imipenem are moderately resistant,with resistance rates of 50.2%,36.1%,17.8%and 12.3%,respectively.Mild resistance to metronidazole,ticacillin+clavulanate,piperacillin+tazobactam and chloramphenicol,the resistance rates were 9.1%,5.5%,4.6%and 0.9%,respectively.Conclusion Culturable Bacteroidetes in children’s intestinal tracts in Hohhot had high resistance to a variety of commonly used antibiotics,especially penicillin,amoxicillin,clindamycin,ticacillin and piperacillin.Among them,Bacteroides fragilis had a higher resistance rate to cefotetam,cefoxitin and imipenem than other Bacteroidetes.The resistance rate of children with a history of broad-spectrum antibiotics to piperacillin,cefotetan,ticacillin,cefoxitin and imipenem was higher than that of children without a history of antibiotic usage,and the resistance of Bacteroides isolated from the intestinal tract of elder children to cefoxitin and imipenem was higher than that of younger children.The resistance of Bacteroides in Chinese children might be seriously underestimated.Systematic monitoring of antibiotic susceptibility tests for Bacteroides in

关 键 词：儿童 肠道 拟杆菌 抗生素耐药性 

分 类 号：R978.1[医药卫生—药品]