2006～2009年苏州地区儿童呼吸道感染金黄色葡萄球菌耐药性分析

Surveillance of Infection and Antibiotic Resistance of Staphylococcus Aureus in Children with Respiratory Tract Infection,2006～2009

目的:研究苏州大学附属儿童医院儿童呼吸道金黄色葡萄球菌(Staphylococcus aureus,SA)的感染情况及其耐药性。方法:对苏州大学附属儿童医院2006年1月至2009年12月间住院的6 404例急性呼吸道感染患儿采用无菌负压吸引法采集新鲜痰液,进行SA培养、分离,观察并总结其呼吸道SA感染情况及相关因素,采用纸片扩散法(K-B法)进行药敏试验,头孢西丁纸片法检测耐甲氧西林金黄色葡萄球菌(MRSA)。结果:6 404例呼吸道感染标本中分离到301株SA,总分离率4.7%,其中MRSA为33株占9.6%。2006、2007、2008、2009年SA年度检出率分别为3.7%(59/1 597)、4.1%(64/1 570)、5.1%(87/1 698)、5.9%(91/1 539),4年年度检出率差异无统计学意义(χ2=0.99,P>0.05)。<1岁组检出率最高。SA对常用抗菌药物耐药率分别为:苯唑西林6.8%～13.2%、青霉素86.4%～96.9%、红霉素52.5%～72.9%、克林霉素15.3%～28.5%、复方新诺明11.5%～16.9%、万古霉素0%、庆大霉素0%～3.4%、环丙沙星0%～3.1%、利福平0%～6.8%。结论:SA是苏州地区儿童呼吸道感染重要的细菌病原之一,婴儿感染多见。分离株对青霉素和红霉素的耐药率高,而对苯唑西林、万古霉素、环丙沙星、庆大霉素和利福平有相对较高的敏感性。

Objective：To investigate the incidence,clinical characteristics and antibiotic resistance of Staphylococcus aureus（SA） in children with acute respiratory tract infection in Suzhou.Methods： The data of bacteria culture in sputum from January 2006 to December 2009 were collected.The incidence of SA and its resistance rate to different antibacterials were calculated and methicillin resistant staphylococcus aureus（MRSA） of these strains were detected.Results： Among 6,404 specimens,4.7% with acute respiratory tract infected SA.The MRSA positive rate of SA was 9.6%.Staphylococcus aureus infection were popular in infants less than 1 year.The resistant rates to Oxacillin、Penicillin、Erythromycin、Clindamycin、SMZ＋TMP、Vancomycin、Gentamicin、Ciprofloxacin and Rifampicin were 6.8%～13.2%,86.4%～96.9%,52.5%～72.9%,15.3%～28.5%,11.5%～16.9%,0%,0%～3.4%,0%～3.1%,and 0%～6.8% respectively.Conclusions： SA was the important bacterial pathogen in respiratory tract infection of children in Suzhou,more common in children younger than 1 year old.SA has strong resistance to Penicillin and Erythromycin,but relatively sensitive to Oxacillin,Vancomycin,Ciprofloxacin,Gentamicin and Rifampicin.