儿科凝固酶阴性葡萄球菌感染及其耐药性分析

Analysis on infection and drug resistance of coagulase negative staphylococcus in children

目的 探讨引起小儿凝固酶阴性葡萄球菌（CNS）感染主要菌株的流行病学状况和其相关的细菌耐药情况。方法 从2000年5月～2004年2月，对在我院住院治疗的小儿进行细菌学检查，同时对发现的相关菌株进行抗生素敏感性检测，对所获得的阳性结果作比较分析。结果 在所进行的8220次细菌学检测中共发现1320株阳性细菌，其中发现202株CNS，占总体检出率的15．3％（202／1320），其中溶血葡萄球菌、表皮葡萄球菌、缓慢葡萄球菌、松鼠葡萄球菌、模仿葡萄球菌等为主要的前5位致病菌。这些阳性菌株中苯唑西林耐药CNS占86．63％。所有菌株对万古霉素保持敏感。结论 CNS感染已经成为儿科临床医疗工作中的重要问题之一，其中苯唑西林耐药CNS菌株呈多重耐药；针对CNS感染。需要在细菌学检查的基础上合理使用抗生素，万古霉素依然是最后的治疗手段。

Objective To explore the epidemiology and drug resistance caused by coagulase negative staphylococcus （CNS） infection in children. Methods Infectious children hospitalized from May 2000 to Feb 2004 were recruited for study. Antibiotic sensitivity were detected in those correlated bacteria strains and then the positive results were compared. Results 1 320 strains were detected among 8 220 bacteriological analyses, of which, 202 strains were CNS, accounting 15.3 % （202/（1320）. Hematolytic staphylococcus, staphylococcus epiderrnidis, torpidity staphylococcus, squirrel staphylococcus and mimicry staphylococcus were the top five pathogenic bacteria. The percentage of oxacillin resistant CNS （ORCNS） in positive strains was 86.63 %, all strains were sensitive to vancomycin. Conclusion It is urgent to handle CNS infection in peadiatric clinic. Moreover, ORCNS strain was often multidrug resistant. Aiming at CNS infection control, antibiotic should be used rationally according to bacteriological assay. Vancomycin is still the last therapeutic choice.