耐甲氧西林葡萄球菌在新生儿中的感染情况及其耐药分析

The study of infection and susceptibility of methicillin-resistance staphylococcus in neonates

目的探讨耐甲氧西林葡萄球菌(MRS)在新生儿中的感染情况及其耐药特点。方法应用API微生物分析鉴定系统对临床送检的163份培养阳性葡萄球菌标本进行鉴定,采用K-B法对鉴定出的MRS菌株进行药敏试验,测定其对青霉素等17种常用抗生素的耐药性。结果MRS总检出率为65.6%,其中MRSA和MRCNS分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌(CNS)的54.7%和72.7%,MRCNS检出率高于MRSA的检出率(P<0.05);血液、气道分泌物、脓液标本中MRS的检出率分别为70.8%、64.1%和51.4%(P<0.01);107株MRS对β-内酰胺类抗生素均耐药,对万古霉素全部敏感,对阿米卡星、庆大霉素、氧氟沙星、利福平、四环素、复方新诺明等较为敏感,对克林霉素、红霉素、阿奇霉素、环丙沙星等敏感性较差。结论MRS为新生儿感染的重要致病菌,CNS感染呈上升趋势,MRS呈多重耐药性,总体β-内酰胺类抗生素耐药,对万古霉素敏感,应根据新生儿的病理生理特点及药敏结果合理使用抗生素。

Objective To explore the situation of methicillin - resistant staphylococcus （MRS） infection and its resistance in neonates. Methods 163 Isolates were cultured and identified by the total automatic API system. The resistance of MRS to 17 antibiotics was detected by K-B method. Results The detection rate of MRS （including MRCNS and MRSA） in all specimens was 65.6% ,and the percentage of MRSA and MRCNS in staphylococcus aureus and CNS was 54. 7% and 72.7%. The detection rate of MRS in blood, sputum and pus was 70. 8 % .64. 1% and 51.4 % （P〈0. 05）. 107 MRS isolates were resistant to β-lactam antibiotics, but were sensitive to vancomycin. The MRS isolates were partially sensitive to amikacin, gentamicin, ofloxacin, rifampicin, tetracycline, and SMZ-TMP, howere, were poorly sensitive to clindamycin, erythromycin, azithromycin, and ciprofloxacin. Conclusion MRS strains have become the major course of neonates＇ infection. The detection rate of MRCNS is higher than that of MRSA. MRS became multidrug resistant.