深圳地区儿童耐甲氧西林金黄色葡萄球菌感染的临床分布与耐药性特点分析

Clinical distribution and drug resistance characteristics of methicillin-resistant Staphylococcus aureus in Children

目的分析深圳地区患儿耐甲氧西林金黄色葡萄球菌(MRSA)感染的临床分布特点和耐药情况,为医院感染控制及临床抗菌药物的合理使用提供依据。方法选择2012年-2015年从18个临床科室送检的各种临床标本中分离得到金黄色葡萄球菌,经VITEK 2COMPACT型全自动细菌培养鉴定仪鉴定为耐甲氧西林金黄色葡萄球菌,并进行药敏试验,检测耐甲氧西林金黄色葡萄球菌的耐药性。结果 5 310株金黄色葡萄球菌中检测出1 446株MRSA,检出率为27.23%;2012年-2015年的检出率分别为22.60%,25.09%,29.05%,29.77%;1 446株MRSA对苯唑西林、青霉素等β-内酰胺类抗菌药物耐药率较高,均为100.00%,未检测到对万古霉素、呋喃妥因和利奈唑胺耐药菌株。结论手术科室应是儿童医院院内MRSA感染的重点监控科室,侵入性操作是引发MRSA感染的重要因素,应加强管理;万古霉素是治疗儿童MRSA感染的首选药物。

OBJECTIVE To analyze the clinical distribution characteristic and drug resistances of methicillin-resistant Staphylococcus aureus（MRSA）from the hospitalized children in Shenzhen,so as to provide evidence for the reasonable application of antibiotics in nosocomial infection control and clinical use.METHODS From Jan.2012 to Dec.2015,S.aureus isolated from various types of bacterial culture specimens of 18 clinical departments were selected,and MRSA were identified by the VITEK-2COMPACT automatic bacteria identification,and drug sensitivity tests were carried out to detected de drug resistance of MRSA.RESULTS Totally 1446 strains of MRSA were detected from 5310 strains of S.aureus,with the total detection rate of 27.23% .From 2012 to 2015,the detection rates were 22.60% ,25.09% ,29.05% ,and 29.77% ,respectively.The 1446 strains of MRSA had high resistant rates to oxacillin,penicillin and other beta lactam antibiotics,which were 100% ,and vancomycin,furantoin and linezolid resistant strains were not detected.CONCLUSIONSurgical departments should be the key monitoring departments of MRSA infection in children′s hospital.Invasive operation is an important factor to cause MRSA infection,and its management should be strengthened.Vancomycin is the first choice for the treatment of MRSA infection in children.