儿童与成人感染金黄色葡萄球菌耐药性对比分析

Resistance to Antibiotics Against Staphylococcus aureus Isolated from Children and Adults in Hangzhou

目的了解临床分离的金黄色葡萄球菌儿童株与成人株的耐药性差异。方法对临床分离的102株金黄色葡萄球菌儿童株与39株成人株,用纸片扩散法作12种抗菌药物体外药物敏感性试验,同时用E-test法测定苯唑西林和万古霉素对金黄色葡萄球菌的最低抑菌浓度(MIC)。结果儿童株与成人株对苯唑西林的耐药率分别为8.8%和69.2%,两者差异有统计学意义(2χ=54.15,P<0.01),均未发现对万古霉素耐药菌株;此外,儿童株与成人株对头孢噻肟、头孢曲松、亚胺培南、红霉素、氧氟沙星、四环素、复方新诺明的耐药性差异有统计学意义(P<0.01);儿童株的苯唑西林MIC50和MIC90分别为0.75μg/ml和3.0μg/ml,而成人株的MIC50和MIC90均>256μg/ml,儿童株对苯唑西林敏感程度和敏感率均明显高于成人。结论金黄色葡萄球菌儿童株对绝大部分抗菌药物的敏感率显著高于成人株,临床使用抗菌药物应根据药敏结果进行选择。

OBJECTIVE To analyze the differences of antibiotics resistance between the Staphylococcus aureus clinical strains isolated from children and adults in Hangzhou. METHODS The susceptibility of antibiotics against S. aureus was performed with both disc diffusion method and E-test method simultaneously in vitro. RESULTS Totally 102 strains from children and 39 from adults, were performed with both disc diffusion and E-test methods in the susceptibility test, 89.2%, 2.0% and 8.8% of all strains were susceptible, intermediate, and resistant to oxacillin, with MIC50 0.75μg/ml and MICg0 3.0μg/ml, respectively, while 28.2%, 2.6% and 69.2% of adults strains were susceptible, intermediate, and resistant to oxacillin, with both MICs0 and MICg0 ~ 256t^g/ml. Oxacillin-resistance rate in adults was significantly higher than that in children （X^2 = 54. 15, P〈0. 001）. All strains were sensitive to vancomycin. MICs0 and MICg0 were 1.5μg/ml and 2.0~g/ml in children strains, while that were all 4.0μg/ml in adults strains. CONCLUSIONS S. aureus isolated from children is more sensitive to common antibiotics than that in adults strains~ sensitive rate to oxacillin is still high in children strains and option of antibiotics should according to the results of drug susceptibility test during the clinical therapy.