儿童感染葡萄球菌的分布及耐药性分析

Analysis on the distribution and medicine resistance of the infectious staphylococcus in children

目的分析西安市儿童医院葡萄球菌的分布及耐药性。方法医院患者各类感染标本中分离出的葡萄球菌506株,用VITEK-32型全自动微生物分析仪进行细菌鉴定,用琼脂纸片扩散(K-B)法进行药敏试验。结果儿童感染的葡萄球菌中,金黄色葡萄球菌占52.4%,其中,耐甲氧西林金黄色葡萄球菌(MRSA)为54.3%;住院患者的金黄色葡萄球菌中MRSA占64.3%,门诊患者的MRSA占20.6%;尿标本的金黄色葡萄球菌中MRSA检出率最高(83.3%)。凝固酶阴性葡萄球菌(CNS)中耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率为85.6%;住院患者CNS中MRCNS占90.8%,门诊患者MRCNS占62.2%;来自血液标本的CNS中MRCNS检出率最高(93.0%)。CNS的分布以表皮葡萄球菌为主(46.5%)。MRSA对β-内酰胺类、喹诺酮类、大环内酯类、氨基糖苷类和四环素有很高的耐药率,均达80.0%以上。MRCNS除氯霉素及利福平外,对所测抗菌药物耐药率均在50.0%以上。结论标本来源不同,葡萄球菌的分布也不同。葡萄球菌耐药率有所上升,对不同抗菌药物耐药性有较大差异。

Objective To analyze the distribution and medicine resistance of staphylococcus of Xi＇an Children Hospital. Methods 506 strains of staphylococcus were isolated from various types of specimens of patients infected, which were treated with VITEK-32 automatic analyzer to identify microbial identification of bacteria, and with K B method to complete drug sensitivity test. Results In the staphylococcus of the children infected, staphylococcus aureus accounted for 52.4%, among which, methicillin-resistant staphylococcus auras （MRSA） was 54.5% ; the MR SA of staphylococcus aureus isolated from hospital inpatients accounted for 64.3%, outpatients＇ MRSN accounted for 20. 6% ; the highest detection rate of MRSA of staphylococcus aureus was from urine specimens, accounting for 83.3 %. Methieillin-resistant eoagulase-negative staphylococci （MRCNS） of coagulase-negative staphylococci （CNS） accounted for 85.6 % ; MRCNS of CNS isolated from patients accounted for 90. 8 %, MRCNS of outpatients accounted for 62.2% ; and the highest detection rate of MRCNS of CNS was from blood, accounting for 93.0K. CNS were mainly distributed with staphylococcus epidermidis （46.5%）. MRSA has a high rate of resistance, with over 80.0 % to 13-1actams, quinolines, macrolides, aminoglycosides and tetracycline. The drug resistance of MRCNS is more than 50.0% excluded chloramphenicol and rifampin. Conclusion As to the different sources of specimens, the distribution of staphylococcus was different. The rate of staphylococcus aureus resistance increased, and there was a great difference to the different antimierobial agents.