不同年龄阶段患者来源的分离菌对头孢曲松耐药情况的国内文献分析

Drug resistant trend of ceftriaxone from patients of different ages based on domestic literatures

目的:分析国内不同年龄阶段患者临床分离菌对头孢曲松的耐药情况。方法:对2009至2014年公开发表的关于头孢曲松细菌耐药性检测的文章进行检索,按一定的纳入和排除标准进行统计和分析。结果:儿童患者阳性菌以肺炎链球菌、流感嗜血杆菌、溶血性链球菌为主,对CRO的耐药率均低于20%。成年患者阳性菌主要为溶血性链球菌、流感嗜血杆菌和副流感嗜血杆菌,耐药率均低于30%,而耐甲氧西林葡萄球菌的耐药率为100%,老年患者检出了较大比例的葡萄球菌,耐药率超过60%,对于阴性菌感染,各年龄阶段均检出了较高比例的大肠挨希菌和肺炎克雷伯菌,其耐药率均超过50%。结论:不同年龄阶段患者阴性菌和老年患者阳性菌对CRO的耐药已非常严重,应进一步做好细菌耐药监测和抗菌药物的合理使用。

Objective： To investigate the drug resistant trend of ceftriaxone （CRO） from patients of different ages. Methods： The references related to cefiriaxone resistance were gathered by the CNKI database during 2009 -2014,and discussed by statistics and analysis according to some inclusion criteria and exclusion criteria. Results：The main strains detected from children were Streptococcus pneumonia,Haemophilus influenza and Hemolytic streptococcus which the drug resistance rates were all below 20%. And the main strains detected from adults were Hemolytic streptococcus, Haemophilus influenza and Haemophilus parainfluenzae which the drug re- sistance rate were all above 60% , but the drug resistance rate of Methicillin resistant Staphylococcus aureus was 100%. Detection of most strains from gerontism was Staphylococcus and its resistance rate was above 60%. For the injections of gram -negative bacteria, the detection rate of Escherichia coli and Klebsiella pneumonia were in a high proportion of different age stage, and resistance rate of them were all above 50%. Conclusion：The status of drug-resistance of gram-negative bacteria detected from all age stage and gram- positive detected from gerontism were very serious, and thus needs more management in drug resistance surveillance and rational use of antibiotics.