凝固酶阴性葡萄球菌耐药性在小儿与成年人的差别

THE DIFFERENCES IN DRUG RESISTANCE OF COAGULASE-NEGATIVE STAPHYLOCOCCUS BETWEEN INFANTS AND ADULTS

目的探讨凝固酶阴性葡萄球菌(CNS)的耐药性在小儿与成年人的差别,为不同科室临床医师合理选用抗菌药物提供依据。方法药敏试验采用纸片扩散法(K-B法),结果判断根据同年美国CLSI/NCCLS判断标准及质控要求。结果①在1602株CNS中,源于儿科487株,源于成年人1115株。儿科组CNS对环丙沙星、阿米卡星、阿奇霉素、利福平、克林霉素、复方新诺明、四环素、庆大霉素的耐药率分别为34.2%、34.9%、74.9%、11.6%、61.0%,42.1%、26.6%、30.9%;成年人组CNS对环丙沙星、阿米卡星、阿奇霉素、利福平、克林霉素、复方新诺明、四环素、庆大霉素的耐药率分别为68.6%、46.7%、81.1%、21.6%、80.5%、50.6%、47.8%、46.5%.两组间耐药率差异有显著性(P<0.05)。所检菌株全部对万古霉素敏感。结论来源于小儿与成年人的CNS对多种抗菌药物的耐药性存在显著差别,临床医师应掌握不同科室细菌耐药规律合理选用抗菌药物。

Objective To explore the differences in drug resistance of coagulase-negative staphylococcus（CNS） between infants and adults so as to provide basis for the application of antibiotics in different clinical departments. Methods Drug sensitive tests were performed according to K-B method, and the results were evaluated according to the requiremtns of CLSI/NCCLS standards. Results Of the 1602 strains of CNS 1115 originated from infants and 1115 from adults.The rates of drug resistance of CNS in infants to compound sulfamethoxazole 34.9 %, 74.9 %, 11.6 %, 61.0 %, 42.1%, 26.6 % and 30.9 % respectively, while the rates of drug resistance in adults to these respective drugs were 68.6% ,46.7% ,81.1% ,21.6% ,80.5% ,50.6% ,47.8% and 46.5% respectively（ P〈0.05）. All these detected strains of CNS were sensitive to vancomycin. Conclusion CNS from infants and adults differs in drug resistance to many antibiotics and the application of antibiotics should be given according to the regularity of different antibiotics.