儿童耐甲氧西林葡萄球菌的感染现状及耐药性

Status of infection and resistance of methicillin-resitant Staphylococcus in children

目的分析儿童耐甲氧西林葡萄球菌(MRS)临床分离株的感染现状及耐药性,为控制和治疗MRS感染提供帮助。方法采用VITEK-32全自动微生物鉴定仪GPI和GPS卡进行菌株鉴定、药敏试验及β-内酰胺酶检测,MRS的检测按照美国临床实验室标准化委员会(NCCLS)2004版的新标准检测。结果从各种标本中分离出101株葡萄球菌,MRS的检出率为79.2%,β-内酰胺酶的检出率为92.1%,MRS的产酶率为100%,甲氧西林敏感的葡萄球菌(MSS)的产酶率为61.9%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)与产酶菌株的耐药率均明显高于甲氧西林敏感的凝固酶阴性葡萄球菌(MSCNS)和非产酶菌株。检出的MRS以MRCNS为主,其中有56.3%来自血液标本,全部MRS对β-内酰胺类抗生素及β-内酰胺类抗生素加酶抑制剂敏感率最低,,对万古霉素耐药率为0。结论MRS菌株已成为儿科感染的主要致病菌,尤其是MRCNS要远远高于MRSA,应引起重视。MRS菌株对β-内酰胺类抗生素及β-内酰胺类抗生素加酶抑制表现出了高度耐药性,要合理应用抗生素,以控制该类菌的感染。

Objective To analyze the status of infection and resistance of methicillin-resitant Staphylococcus （MRS） from isolates in children, giving a help in the treatment of infection of MRS. Methods Vitex-32 automicroscan GPI and GPS cards were used to identify the specimen and conduct drug-susceptibility test,and to detect β-lactamase. MRS were identified based on new criteria published in NCCCLS 2004. Results All strains of Staphylococcus were isolated from all specimen. The isolated rate of MRS was 79.2% and β-lactamase 92.1%. The positive rates of β-lactamases of MRS and MSS were 100% and 61.9 %. The drug-resistance rates of MRCNS and β-lactamase-productive strains were remarkblely higher than MSCNS and β-lactamase-unproductive strains. All the MRS strains were highly resistant to β-lactamase antibiotics tested, and were highly sensitive to vancomycin. Conclusion MRS strains have become major pathogenic bacteria in pediatric infection, especially MRCNS should be paid more attention. MRS strains show highly resistant to β-lactamase antibiotics tested, so antibiotics should be used reasonably to control the infection caused by these bacteria.