儿科金黄色葡萄球菌感染现况及耐药谱分析

Current status of staphylococcus aureus infection in pediatrics and the analysis of the relative antibiotic resistance spectrum

目的分析住院患儿耐甲氧西林金黄色葡萄球菌(MRSA)与甲氧西林敏感金黄色葡萄球菌(MSSA)检出状况。方法对首都儿科研究所2005—2009年间35352份标本中检出的金黄色葡萄球菌鉴定结果和药敏试验进行回顾性分析。结果共分离出463株金黄色葡萄球菌,培养标本总检出率1.31%。金黄色葡萄球菌来源构成比中,前3位标本依次为脓液(24.26%)、分泌物(7.32%)和呼吸道标本(6.73%),血液标本仅为0.20%。463株金黄色葡萄球菌中MRSA48株,占10.37%;MSSA415株,占89.63%。2005—2009年度检出率分析结果显示,MRSA株检出率呈逐年上升趋势。研究中发现1株耐万古霉素的金黄色葡萄球菌,但对利奈唑胺敏感。26株MRSA药敏分析提示,92.3%为多重耐药株。结论儿科MRSA阳检率虽低于成人,但呈现逐年上升趋势,提示儿科需加强对MRSA株与药敏情况监测,尤其是对利奈唑胺等新药监测。

Objective To investigate the current status of specimen distribution of Staphylococcus aureus isolated, the infection rates and resistance situation of methicillin-resistant Staphylococcus aureus （MRSA） and methicillin-sensitive Staphylococcus aureus （MSSA） in sick in-patients of children from 2005 to 2009. Methods A retrospective analysis was made on Staphylococcus aureus detected in 35 352 specimens in Capital Institute of Pediatrics from 2005 to 2009. Results A total of 463 stains of Staphylococcus aureus was isolated from specimens in sike children and the total detection rate was 1.31%. The top three types of specimens with high detection rates were pus , secretion from umbilicus, eyes and wounds as well as respiratory tract specimen, such as sputum, swabs and broncho-alveolar lavage fluids.Their detection rate was 24.26%, 7.32% and 6.73% respectively. However, detection rate of blood occupied 0.20% only. In these 463 stains, MRSA was detected in 48 stains （10.37%）and MSSA was in 415 stains （89.63%）. The detection rates of MRSA increased gradually year by year. Meanwhile, 92.3% of them were multiple-resistant. Conclusion MRSA has an increased trend since 2005 in childpatients with infections.lt will be more and more important for us to focus on treatment of MRSA infection in pediatrics and monitoring of multiple-resistant MRSA.