儿童皮肤软组织金黄色葡萄球菌感染的耐药分析

Drug resistance of Staphylococcus aureus causing skin and soft tissue infection in children

目的对儿童皮肤软组织感染中金黄色葡萄球菌的耐药性进行分析,有效预防与控制多药耐药医院感染的发生,指导临床抗菌药物的合理使用。方法随机选取2012年1月-2014年1月医院收治的200例皮肤组织感染患儿,通过鼻拭子或感染部位标本进行培养,对分离出的金黄色葡萄球菌进行药敏试验,并对病原菌耐药性进行统计分析。结果 200例皮肤组织感染患儿中共分离出金黄色葡萄球菌137株,阳性率为68.5%;137例金黄色葡萄球菌致皮肤组织感染患儿中,儿科病房占72.3%、儿童内科占19.7%、新生儿科占8.0%;感染部位分布以脐部、手指甲沟、颈部、脚趾甲沟、上肢为主,分别占20.44%、14.60%、13.87%、12.41%、10.95%;金黄色葡萄球菌对青霉素、磺胺甲噁唑/甲氧苄啶、氯霉素、红霉素的耐药率较高,均>50.00%,对氨苄西林/舒巴坦、苯唑西林、头孢唑林、万古霉素较敏感,耐药率<14.00%。结论针对皮肤软组织感染患儿临床应结合金黄色葡萄球菌耐药分析结果选取耐药率较低的抗菌药物进行治疗,同时严格开展日常护理,有效改善患儿临床感染症状。

OBJECTIVE To investigate the drug resistance of the Staphylococcusaureus causing skin and soft tissue infection in the children,effectively control the multidrug-resistant organisms infections,and provide guidance for the reasonable clinical use of antibiotics.METHODS A total of 200 children with skin and soft tissue infections, who were treated in the hospital from Jan 2012 to Jan 2014,were randomly recruited as the study objects,then the nasal swabs or infection site specimens were cultured,the drug susceptibility testing was performed for the isola-tion of S.aureus strains,and the drug resistance of the pathogens was statistically analyzed.RESULTS A total of 137 strains of S.aureus have been isolated from the 200 children with skin and soft tissue infections,with the posi-tive rate of 68.5%.Of the 137 strains of S.aureus isolated from the children with skin and soft tissue infections, 72.3% were from the pediatric ward,19.7% from the children′s internal medicine department,8.0% from the neonatal department.The umbilical region,fingernails ditch,neck,toenails ditch,and upper limb were the pre-dominant infection sites,accounting for 20.44%,14.60%,13.87%,12.41%,and 10.95%,respectively.The S.aureus isolates were highly resistant to penicillin,sulfamethoxazole-trimethoprim,chloramphenicol,and eryth-romycin,with the drug resistance rate more than 50.00%,while the strains were highly susceptible to ampicillin-sulbactam,oxacillin,cefazolin,and vancomycin,with the drug resistance rate less than 14.00%.CONCLUSION For the treatment of the children with skin and soft tissue infections,the antibiotics should be used on the basis of the results of drug susceptibility testing for the S.aureus strains,meanwhile,the daily nursing should be rigidly conducted so as to effectively improve the clinical infection symptom.