儿童呼吸道革兰阳性菌中金黄色葡萄球菌肺炎病原菌耐药性的临床研究

Resistance of Pathogenic Bacteria of Staphylococcus Aureus Pneumonia in Children with Respiratory Tract Gram Positive Bacteria

目的:分析儿童呼吸道革兰阳性菌中金黄色葡萄球菌肺炎病原菌的耐药性,供临床用药参考。方法:采用便利抽样法收集2018年1月~2019年1月于本院收治的符合《金黄色葡萄球菌肺炎疾病诊治指南》标准的68例患儿,分析其中金黄色葡萄球菌肺炎病原菌临床特点和耐药性。结果:患儿支气管源性金黄色葡萄球菌的咳痰、喘息发生率高于血源性;意识障碍发生率低于血源性(P<0.05)。68株菌株中对青霉素和氨苄西林耐药性达到100%,其他抗生素中红霉素最不敏感性。甲氧西林敏感金黄色葡萄球菌(MSSA)菌株对苯唑西林、头孢西丁、红霉素、克林霉素、利福平、阿莫西林的敏感性高于耐甲氧西林金黄色葡萄球菌(MRSA,P<0.05)。结论:对金黄色葡萄球菌耐药情况进行监测,有助于及时掌握儿童金黄色葡萄球菌肺炎病原体的耐药规律,从而制定最佳的经验治疗方案。

Objective:To analyze the resistance of pathogenic bacteria of Staphylococcus aureus pneumonia in children with Gram-positive bacteria in respiratory tract for clinical diagnosis and treatment.Methods:68 children qualified for the standards in the Treatment Guideline for Staphylococcus Aureus Pneumonia and treated in our hospital from January 2018 to January 2019 were collected by convenient sampling method,and the clinical characteristics and drug resistance of pathogenic bacteria in Staphylococcus aureus pneumonia were analyzed.Results:The incidence of sputum and wheezing in children with bronchogenic Staphylococcus aureus was higher than that of hematogenous,and the incidence of consciousness disorder was lower than that of hematogenous(P<0.05).In 68 strains,resistance rate forpenicillin and ampicillin reached 100%.Among other antibiotics,erythromycin was with the lowest rate of sensitivity.The sensitivity of MSSA strains to benzacillin,cefoxitin,erythromycin,clindamycin,rifampicin and amoxicillin was higher than that of MRSA(P<0.05).Conclusion:Monitoring the drug resistance of Staphylococcus aureus is helpful for understanding the drug resistant pattern of pathogen in children with Staphylococcus aureus pneumonia and to formulate the best empirical treatment plan.