2009～2010年儿童血培养283株葡萄球菌耐药性分析

摘要

Objective To study the drug resistance rates of 283 staphylococcus strains isolated from blood culture in children. Methods Blood specimens in medium in bottle were cultured and then rowed on solid medium containing blood. The bacteria were identified with Vitek system and additional analysis on drug resistance was finished with WHONET 5.4 software.X2 test was used in the study. Results Two hundred and eighty - three staphylococcus strains were isolated and the constituent ratio was 58. 0% , and 83. 4% of the strains were isolated from neonate. Staphylococcus epidermidis (48.4% ) was the most common strains,followed by staphylococcus simulation ( 13. 4% ) and staphylococcus haemolpicus ( 12. 7% ). Only 5 staphylococcus aureus strains ( 1.8% ) were identified in the study. Of all 283 strains,98. 8% were β lactamase positive and resistant to penicillin C,and 76. 7% of all strains were resistant to oxacillin. The re-sisitant rates to erythromycine, sulfamethoxazole, clindamycin, levofloxacin and gentamicin were 86. 6% ,60. 1% ,39. 6% ,38. 9% and 33. 9% , respectively. All strains were sensitive to vancomycin and linezolid. The resistant rate to oxacillin of staphylococcus epidermidis was 65.7% , which was significantly higher than that of staphylococcus simulation 97.4% (X2 = 13.44 ,P < 0. 05) and staphylococcus hae-molyticus 94.4% (X2 = 10. 23 ,P <0.05). Conclusion The resistant rates of staphylococcus to oxacillin were high,however, the resistant rate of staphylococcus epidermidis to oxacillin was lower than that in other staphylococcus. It is imperative to choose antibiotics according to the results of drug sensitive test.%目的 了解笔者医院儿童血培养葡萄球菌的分离情况、菌种分布和耐药特点.方法 血标本增菌、划种后以细菌鉴定卡和药敏卡经Vitek系统进行菌株鉴定和药敏试验,用WHONET 5.4软件分析耐药性,统计分析采用,检验.结果 2009年6月～2010年12月共分离到葡萄球菌283株,分离率为1.4％,占阳性结果 的构成比达58.0％,其中83.4％的菌株来自新生儿；最多见的是表皮葡萄球菌,占48.4％,其次是模仿葡萄球菌,占13.4％,第3位是溶血葡萄球菌,占12.7％.药敏结果 显示98.8％的菌株产生β内酰胺酶而对青霉素G耐药,76.7％的菌株对苯唑西林耐药,对红霉素、复方新诺明、克林霉素、左氧氟沙星、庆大霉素的耐药率分别为86.6％、60.1％、39.6％、38.9％和33.9％.所有菌株均对万古霉素和利奈唑胺敏感.表皮葡萄球菌对苯唑西林的耐药率为65.7％,显著低于模仿葡萄球菌和溶血葡萄球菌中97.4％(x2＝ 13.44,P＜0.05)和94.4％(x2＝10.23,P＜0.05)的耐药率.结论 儿童血培养来源的葡萄球菌对苯唑西林的耐药率维持在高水平,但表皮葡萄球菌对苯唑西林的耐药率低于其他菌种,临床应根据药敏结果 合理选择抗生素.