儿科呼吸道致病菌氨基糖苷类抗生素耐药性

Antibiotic resistance of aminoglycosides among pathogens from respiratory tract in paediatrics

目的探讨儿科呼吸道感染病原菌对氨基糖苷类抗生素耐药机制,监测儿科细菌耐药性变化趋势。方法采集2005年4月-2006年5月儿科上呼吸道感染性标本,常规方法分离培养细菌,琼脂纸片（K-B）法进行抗菌药物敏感性监测,PCR检测氨基糖苷类修饰酶基因,PCR产物克隆测序。结果242份上呼吸道感染标本共分离出革兰阴性杆菌172株（46.9%）,对链霉素耐药率超过50%以上;对庆大霉素、卡那霉素、阿米卡星和奈替米星耐药率均超过35%,对衣替米星和地贝卡米星耐药率低于15%。对链霉素耐药细菌携带ANT（3″）基因,对庆大霉素耐药携带AAC（3′）基因。结论吉林地区儿科呼吸道感染性疾病分离出的革兰阴性杆菌对链霉素耐药率最高,对衣替米星和地贝卡米星耐药率最低,携带单一类型的氨基糖苷类修饰酶基因。

Objective To investigate the mechanism of pathogens＇ resistance to aminoglycosides in paediatrics＇infectious diseases in Jilin regions and guide the rational use of antibiotics. Methods 242 cases of specimens from the respiratory tract were collected, and the bacteria were isolated and identified from April in 2005 to May in 2006. The drug susceptibility were tested, the aminoglycosides modifying enzymes were detected by PCR technique and the PCR conducts were cloned and sequenced. Results 366 strains of bacteria were isolated from 242 specimens including 172 strains of Gbacillus accounting for 40 percent of K. pneumoniae and 28.8 percent of E. coli. The most frequent resistance to streptomycin were over 50%, the resistance to gentamycin, kanamycin, amikacin, netimycin was over 35 % and the resistance to etimycin and dibamycin was lower 15 %. The bacteria which were resistant to streptomycin and gentamycin carried the ANT（3″）and AAC（3′）gene respectively. Conclusion The bacteria from the respiratory tract have the highest resistant rates to streptomycin and the lowest resistant rates to etimycin and dibamycin, which harboured the same type of aminoglycosides modifying enzymes genes used in treating diseases.