儿童常见病原菌耐药性监测分析

Surveillance on Antibiotic Resistance of Common Pathogens in Children

目的对儿童常见病原菌的耐药菌株进行耐药性监测,为医院感染的控制和临床合理使用抗菌药物提供参考。方法用细菌自动鉴定仪Vitek60对大肠埃希菌、肺炎克雷伯菌、肠球菌和金黄色葡萄球菌进行鉴定和抗菌药物敏感试验。结果耐甲氧西林金黄色葡萄球菌(MRSA)、产ESBLS的大肠埃希菌和产ESBLS的肺炎克雷伯菌、青霉素不敏感肺炎链球菌(PNSP)和耐万古霉素的肠球菌(VRE)的检出率逐年上升。不产ESBLS肺炎克雷伯菌对头孢唑林、菌必治、头孢他定的耐药率较低,未发现亚胺培南耐药菌株。结论MRSA和HMSSA、产ESBLs肺炎克雷伯菌和不产ESBLs肺炎克雷伯菌、产ESBLs大肠埃希菌和不产ESBLs大肠埃希菌、PNSP和青霉素敏感肺炎链球菌(PSSP)之间的耐药性存在很大的差别,且有严重的交叉耐药现象。

Objective To provide references for nosocomial infection control and reasonable antibacterial usage by surveying antibiotic resistance of commom pathogens in children. Methods Escherrichia coli, klebsiella pneumonia, enteroceccus and staphylococcus aureus were detected by automated bacterial identification system as well as antibiotic susceptibility test. Results The detective rates of methicillin-resistant staphylococcus aureus （MRSA）, escherrichia coli and klebsiella pneumonia which produce ESBLs, penicillin-nonsuseeptible streptococcus pneumonia （PNSP） and vancomycin-resistant euteroccus （VRE） were increasing year by year. The resistance rates of cefazalin, ceftriaxone and ceftazidime were low in klebsiella pneumonia without producing ESBLs. However, ESBLs-positive anti ESBLs-negative klebsiella pneumonia were all. sensitive to Imipenem. Conclusion There are large differences of antibiotic resistance between MRSA and methicillin- susceptible staphylococcus aureus （MSSA）, ESBLs-positive and ESBLs-negative klebsiella pneumoniae, ESBLs-positive and ESBLs-negative eseherrichia coli, PNSP and penicillin-susceptible streptococcus pneumonia （PSSP） respectively as well as serious multi-cross resistance.