脓疱疮患儿皮肤感染金黄色葡萄球菌的耐药性研究

Drug resistance of Staphylococcus aureus causing skin infections in children with impetigo

目的观察和分析患儿皮肤感染金黄色葡萄球菌的耐药性,为临床选择适当的抗菌药物提供参考依据。方法选取2010年1月-2012年12月246例脓疱疮皮肤感染患儿作为研究对象,对其送检感染分泌物标本检出的金黄色葡萄球菌进行分离、培养和耐药性检测,菌株通过触酶试验、血浆凝固酶试验及革兰染色进行菌种鉴定,用琼酯稀释法进行药敏试验。结果在脓疱疮分泌物中分离培养出246株金黄色葡萄球菌,其对青霉素、红霉素和克林霉素的耐药率较高,分别为94.7%、86.6%和75.6%,其中对青霉素的耐药率呈现逐年上升的趋势;对苯唑西林、环丙沙星、庆大霉素的耐药率较低,分别为0.8%、4.5%、15.8%,未发现对头孢菌素、莫匹罗星、夫西地酸和万古霉素耐药菌株。结论引发脓疱疮的金黄色葡萄球菌对青霉素等抗菌药物的耐药率较高,应加强对其耐药性的监测,临床医师应根据监测结果选择适当的抗菌药物进行治疗。

OBJECTIVE To observe the drug resistance of Staphylococcus aureus causing skin infections in children so as to provide guidance for reasonable clinical use of antibiotics.METHODS Totally 246 children with impetigo complicated with skin infections who were treated in the hospital from Jan 2010 to Dec 2012 were recruited as the study objects,then the bacterial isolation and culture were performed,and the drug resistance of the S.aureus strains isolated from the infective secretions specimens was observed.The strains were identified through the catalase test,plasma coagulase test,and gram staining,and the drug susceptibility testing was performed by using the agar dilution method.RESULTS A total of 246 strains of S.aureus have been isolated from the impetigo secretions.The drug resistance rates of the S.aureus to penicillin,erythromycin,and clindamycin were 94.7%,86.6%,and 75.6%,respectively,and the drug resistance rate to penicillin was increased year by year;the drug resistance rates to oxacillin,ciprofloxacin,and gentamicin were 0.8%,4.5%,and 15.8%,respectively.No strain resistant to cephalosporin,mupirocin,fusidine,or vancomycin was found.CONCLUSION The S.aureus causing impetigo is highly resistant to the antibiotics such as penicillin.It is necessary to strengthen the monitoring of the drug resistance and choose appropriate antibiotics for treatment on the basis of the results of the monitoring.