山东某三甲医院儿童急性骨髓炎致病菌及耐药性分析

目的 总结山东大学附属儿童医院儿童急性骨髓炎脓液培养及药敏结果，为临床抗生素的使用提供参考。方法 收集我院2018年1月至2023年1月诊治的115例儿童急性骨髓炎的病例资料进行回顾性分析，其中男孩71例，女孩44例，年龄19天～15岁，对脓液培养结果及药敏结果进行总结分析。结果 115例患儿中，53例为甲氧西林敏感性金黄色葡萄球菌（methicillin-susceptible Staphylococcus aureus,MSSA）,33例为耐甲氧西林金黄色葡萄球菌（methicillin-resistant Staphylococcus aureus,MRSA）,2例为肺炎链球菌，1例为肠炎沙门菌，1例为流感嗜血杆菌，25例为阴性。53例MSSA中，51例对氨苄西林耐药，42例对克林霉素耐药，41例对红霉素耐药，仅1例对庆大霉素耐药，所有患儿均对青霉素耐药，均对阿莫西林、头孢西丁、苯唑西林、万古霉素和利奈唑胺敏感。33例MRSA中，27例对克林霉素耐药，27例对红霉素耐药，3例对庆大霉素耐药，所有患儿均对氨苄西林、阿莫西林、头孢西丁、苯唑西林和青霉素耐药，均对万古霉素和利奈唑胺敏感...

Analysis of Pathogenic Bacteria and Drug Resistance in Children with Acute Osteomyelitis in Shandong Province

Objective To summarize the results of pus-culture and drug sensitivity in children with acute osteomyelitis in Children''s Hospital Affiliated to Shandong University and to provide reference for clinical antibiotic use. Methods The data of 115 children with acute osteomyelitis diagnosed and treated from January 2018 to January 2023 were retrospectively analyzed, including 71 cases of boys and 44 cases of girls, aged from 19 days to 15 years. The results of pus-culture and drug sensitivity were summarized and analyzed. Results Of the 115 children, 53 were infected with methicillin-sensitive Staphylococcus aureus (MSSA), 33 with methicillin-resistant Staphylococcus aureus (MRSA), 2 with Streptococcus pneumoniae, 1 with Salmonella enteritidis, 1 with Haemophilus influenzae, and 25 were negative. Among the 53 cases of MSSA, 51 were resistant to ampicillin, 42 to clindamycin, 41 to erythromycin, and only 1 to gentamicin. All the children were resistant to penicillin and sensitive to amoxicillin, cefoxitin, benzacillin, vancomycin and linezolid. Among the 33 cases of MRSA, 27 cases were resistant to clindamycin, 27 to erythromycin, and 3 to gentamicin. All the children were resistant to ampicillin, amoxicillin, cefoxitin, benzacillin and penicillin, and sensitive to vancomycin and linezolid. Conclusion Staphylococcus aureus is the main causative agent of acute osteomyelitis in children, and all are susceptible to vancomycin and linezolid. MSSA has a high resistance rate to ampicillin, clindamycin and erythromycin.