儿童下呼吸道感染的金黄色葡萄球菌耐药性分析

Drug Resistance Analysis of 89 Strains of Staphylococcus aureus Isolated from Sputum Specimens of 4 238 Children with Lower Respiratory Tract Infection

对 4 2 38例下呼吸道感染患儿深部痰液标本中的金黄色葡萄球菌进行分离培养 ,并用细菌自动分析系统Vitek 6 0进行菌种鉴定和药物敏感试验。金黄色葡萄球菌分离阳性率为 2 .1% (89/ 4 2 38)。所分离的89株金黄色葡萄球菌中 ,95 .5 % (85 / 89)菌株产 β 内酰胺酶 ;但仅 4 .5 % (4 / 89)菌株耐苯唑西林 (MRSA) ,其中 3株显示多重耐药。 96 .6 %和 4 8.3%的菌株分别对青霉素和红霉素耐药 ,14 .6 %～ 2 5 .9%分别对四环素、林可霉素、复方新诺明耐药 ;对其余临床常用抗生素 ,如庆大霉素、苯唑西林、氨苄西林 /舒巴坦、阿莫西林 /克拉维酸、头孢唑啉、环丙沙星、左氧氟沙星等的耐药率均低于 10 %。上述实验结果提示 ,本地区引起患儿下呼吸道感染的金黄色葡萄球菌对多数临床常用抗生素仍敏感 ,β 内酰胺酶阳性菌株极为普遍 ,但MRSA所占比例不高。

Staphylococcus aureus strains in deep sputum specimens of 4 238 children with lower respiratory tract infection were isolated and cultured. By using bacterium automatic analysis system Vitek 60, identification and drug resistance of the isolates were performed. In the 4 238 specimens, 2.1%(89/4 238)were positive for S.aureus. Of the isolated 89 strains of S.aureus,95.5%(85/89)could produce β-lactamase and 4.5%(4/89)belonged to MRSA.Three of the 4 MRSA strains showed multiple drug resistance. 96.6% and 48.3% of the strains were resistant to penicillin and erythromycin, respectively, while 14.6%～25.9% of the strains were resistant to SMZ co, lincomycin and streptomycin. Resistance rates of the strains to the tested common antibiotics such as gentamycin, oxacillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, cefazole, ciprofloxacin and levofloxacin were lower than 10%. The results of this study indicated that drug resistance of S.aureus strains causing lower respiratory tract infection in children was still sensitive to most of the common antibiotics clinically used, and β-lactamasestrains of S.aureus were high frequently present but the proportion of MRSA in the isolates was low. ;