68株急性肾小球肾炎暴发相关A组链球菌耐药性分析

Antibiotic resistance analysis on 68 Group A streptococcus strains isolated during acute glomerulonephritis outbreak

目的对贵州两县急性肾小球肾炎暴发相关A组链球菌(group A streptococcus,GAS)进行抗生素耐药性分析,探讨耐药监测在GAS疫情处理与控制中的作用。方法采用E-test法测定GAS对8种抗生素(氨苄青霉素、头孢曲松、万古霉素、红霉素、四环素、左氧氟沙星、氯霉素、克林霉素)的敏感性。结果68株GAS对红霉素和四环素的耐药率分别为88.2%和97.1%。不同人群、不同学校来源菌株对抗生素的敏感性无统计学差异(P>0.05)。结论健康携带者与患者分离菌株间抗生素耐药性的一致性提示对自然人携带GAS的耐药监测对疾病控制与疫情处理的重要性;当地治疗GAS感染不宜使用红霉素,青霉素仍为治疗GAS感染的首选药物,对青霉素过敏者可选头孢菌素类抗生素替代。

Objective To investigate the antibiotic resistance status of Group A streptococcus （GAS） isolated from elementary school children during acute glomerulonephritis （AGN） outbreak at two counties of Guizhou province of China, and to study the importance of antibiotic resistance surveillance for the treatment and control of GAS disease outbreaks. Methods Susceptibility to ampicillin, ceftriaxone, vancomycin, erythromycin, tetracycline, levofloxacin, chloramphenicol, clindamycin was assessed by E- test. Results The resistant rates of 68 GAS isolates to erythromycin and tetracycline were 88.2% and 97.1% , respectively. There are not significant differences among the resistance rates of GAS from different groups or different schools of children （P 〉0.05）. Conclusions Similar rates of antibiotic resistance between asymptomatic carriers and patients indicate the importance of antibiotic resistance surveillance for health population in the control of GAS diseases and treatment of outbreaks; Erythromycin should not be recommended for the treatment of GAS infections at two counties of Guizhou Province of China; Penicillin is still the first choice for the treatment of GAS infections and cephems are acceptable alternatives for penicillin allergic individuals.