儿童与成人患者临床分离金黄色葡萄球菌诱导克林霉素耐药的差异分析  

Analysis of the differences in inducible clindamycin resistance among staphylococcus aureus clinically isolated from pediatric and adult patients

作　　者：唐金蓉 贾宏娟 肖海娟 TANG Jinrong;JIA Hongjuan;XIAO Haijuan(Department of Clinical Laboratory,Mianyang Hospital of Traditional Chinese Medicine/Mianyang Hospital Affililiated to Chengdu University of Traditional Chinese Medicine,Mianyang 621000,China;Deparment of Clinical Laboratory,Lianshui People’s Hospital Affiliatedt Kangda College of Nanjing Medical University,Huai'an 223200,China)

机构地区：[1]绵阳市中医医院/成都中医药大学附属绵阳医院,四川绵阳621000 [2]南京医科大学康达学院附属涟水人民医院,江苏淮安223200

出　　处：《黑龙江医药科学》2025年第2期15-18,共4页Heilongjiang Medicine and Pharmacy

基　　金：绵阳市卫健委补助项目,编号:202110;成都中医药大学“杏林学者”科研课题,编号:XJ2023007801。

摘　　要：目的:研究儿童与成人患者临床分离金黄色葡萄球菌的药敏情况及诱导克林霉素耐药试验结果差异,为临床用药提供依据。方法:采用回顾性分析的方法,共纳入绵阳市中医医院2020年1月至2022年12月临床分离565株金黄色葡萄球菌,按年龄分为儿童组(年龄为1个月~14岁)和成人组(年龄>14岁),分析两组人群分离金黄色葡萄球菌对临床抗菌药物的耐药性差异和诱导克林霉素耐药试验结果的差异。结果:儿童组耐甲氧西林金黄色葡萄球菌(MRSA)检出率为45.9%,高于成人组的26.7%。两组患者金黄色葡萄球菌的药敏情况也存在差异。克林霉素耐药方面,儿童组和成人组在MRSA中均以结构型耐药(cMLSB)为主,儿童组在甲氧西林敏感金黄色葡萄球菌(MSSA)中以红霉素耐药克林霉素敏感(ER+CS)为主,占46.5%,成人组以红霉素敏感克林霉素敏感(ES+CS)为主,占48.9%,两组间有统计学差异(P<0.05)。儿童组和成人组在MRSA、MSSA中诱导克林霉素试验阳性率均很高,两组间无统计学差异(P>0.05),总阳性率为93.3%。结论:儿童组的MRSA检出率较成人组高,应引起重视,加强院感防控工作,防止院内传播。儿童组在MSSA中红霉素耐药克林霉素敏感占比高,更应重视诱导克林霉素耐药试验。儿童组和成人组克林霉素耐药率高且诱导克林霉素耐药试验阳性率高,使用该类抗生素前一定要进行药敏试验和诱导克林霉素耐药试验,并根据药敏结果慎重选择。Objective:To investigate the differences in drug sensitivity and inducible clindamycin resistance among Staphylococcus aureus clinically isolated from pediatric and adult patients,providing a basis for clinical medication.Methods:A retrospective analysis was conducted,including 565 strains of Staphylococcus aureus clinically isolated from Mianyang Traditional Chinese Medicine Hospital between 2020 and 2022.The patients were divided into children group(aged 1 Month-14 years)and adult group(aged over 14 years).The differences in drug resistance to clinical antibiotics and inducible clindamycin resistance between the two groups were analyzed.Results:The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)in the children group was 45.9%,higher than the 26.7%in the adult group.There were also differences in drug sensitivity among Staphylococcus aureus isolated from the two patient groups.In terms of clindamycin resistance,both the children and adult groups showed a predominance of constitutive resistance(cMLSB)in MRSA.In methicillin-sensitive Staphylococcus aureus(MSSA),the children group predominantly showed erythromycin-resistant and clindamycin-sensitive(ER+CS)strains,accounting for 46.5%,while the adult group predominantly showed erythromycin-sensitive and clindamycin-sensitive(ES+CS)strains,accounting for 48.9%,and there was a statistically significant difference between the two groups(P<0.05).Both the children and adult groups had high positive rates of inducible clindamycin resistance tests in MRSA and MSSA,with no statistical difference between the two groups(both P>0.05),and the overall positive rate was 93.3%.Conclusion:The detection rate of MRSA in the children group is higher than that in the adult group,which warrants attention and strengthened infection control measures to prevent nosocomial transmission.The children group has a high proportion of ER+CS strains in MSSA,which necessitates greater emphasis on inducible clindamycin resistance testing.Both children and adult groups have high r

关 键 词：儿童 成人 金黄色葡萄球菌 诱导克林霉素耐药 

分 类 号：R446.5[医药卫生—诊断学]