儿童葡萄球菌感染的分布及耐药性分析1.docVIP

儿童葡萄球菌感染的分布及耐药性分析 谢永强 邓秋连 黄勇 钟华敏 陈卓瑶 广州市儿童医院（510120） 摘要 目的 探讨儿童葡萄球菌的感染现状及耐药特点，为临床合理使用抗生素有效控制感染提供参考。方法 对广州市儿童医院细菌室2002年1月-2003年12月从各类临床标本中分离到的685株葡萄球菌的来源及耐药特征进行回顾分析。结果 葡萄球菌在儿科的感染很普遍，凝固酶阴性葡萄球菌（CNS）是菌血症/败血症的主要病原菌，金黄色葡萄球菌（SA）是儿童皮肤感染和创口感染的主要病原菌，耐甲氧西林葡萄球菌（MRS）占很大比例（占40.7%，279/685）；儿科感染的葡萄球菌对青霉素、红霉素的耐药率相当高（75%），且多数是多重耐药株，对四环素、复方新诺明、喹诺酮类或氨基糖苷类抗生素也有不同程度的耐药。结论 治疗MRS感染首选万古霉素、替考拉宁，对甲氧西林敏感葡萄球菌（MSS）感染的治疗可用苯唑西林、敏感的β-内酰胺类抗生素及加酶抑制剂的复合制剂，建议联合用药。应重视儿科感染病原菌的耐药性监测，及时掌握病原菌的耐药动态，合理用药是延缓和降低耐药菌株产生的重要手段。 关键词 葡萄球菌；耐药性；抗生素；感染 Distribution and Drug-resistance Analysis of the Children’s Staphylococcus Infection Xie Yongqiang，Deng Qiulian，Huang Yong ，et al. Guangzhoushi Children’s Hospital.510120 【Abstract】 Objective To investigate the distribution and the drug resistant characteristics of staphylococcus in the children’s patients . Methods The distribution and the susceptibility of 685 strains staphylococcus were investigated retrospectively ,which were clinically isolated from children’s hospital from January 2002 to December 2003.Results Staphylococci infection in children’s patients is very common .Coagulase negative staphylococcus(CNS) is the major pathogenic bacteria of septicemia,staphylococcus aureus is the major pathogenic bacteria of skin infection Methicillin restistance staphylococcus(MRS) account for 40.7%(279/685).Results of susceptibility test showed that the resistance rates of penicillin and erythromycin were high (75%),Most of them were multi drug resistance,the different resistance rates are found in tetracyclines, trimethoprim/sulfamethoxazole,quinolones and aminoglycosides.Conclutions To treat methicillin restistance staphylococcus(MRS) firstly use vancomycin and teicoplanin;to cure methicillin susceptive staphylococcus(MSS),we can use bristopen,susceptive β-lactams and enzyme inhibitor.To grasp the resistant microorganism and correctly use antibiotic can decrease resistance rates. 【Key words】 Staphylococcus;Drug Resistance;Antibiotic;Infection 葡萄球菌是医院感染的重要病原菌，临床上抗生素的广泛使