山东济南地区猩红热的病原学检测及药敏分析

目的观察济南地区猩红热患者的病原菌及对目前常用抗菌药物的敏感性。方法对2011年1月至2013年6月济南市传染病医院住院的猩红热患者，进行咽拭子采集、细菌培养，细菌鉴定后采用K-B纸片扩散法进行药敏试验。结果50例猩红热患者培养出A组13型溶血性链球菌（GAS），GAS对青霉素、氨苄青霉素、头孢曲松、头孢噻肟钠、头孢呋辛、头孢唑林、头孢唑肟及万古霉素的敏感性均为100％；对左旋氧氟沙星、氧氟沙星的敏感率为94％、中介率为6％；对克林霉素的敏感率为8％、中介率为4％、耐药率为88％；对红霉素的耐药率为100％。结论山东济南地区猩红热的病原菌GAS对大环内酯类抗菌药物和克林霉素耐药率高，对青霉素类、头孢菌素类及喹诺酮类抗菌药物具有高度敏感性，青霉素类仍然是治疗猩红热的首选药物。

Etiology detection and drug sensitive test in patients with scarlet fever in Jinan,Shandong Province

Objective To investigate pathogenic bacteria causing scarlet fever and its sensibility to common antibacterial drugs in Jinan of Shandong Province. Methods Scarlet fever patients hospitalized in Jinan Infectious Diseases Hospital from January 2011 to July 2013 were collected, restrospectively. Collection and cultivation of throat swabs were done in these patiens and then drug sensitive tests were proceeded by K-B paper slip diffusion method. Results Group A β-haemolytic streptococcus （GAS） were cultivated in 50 patients with scarlet fever. The sensibility rate of GAS to penicillin, ampicillin, ceftriaxone, cefotaxime sodium, cefuroxime, cefazolin, ceffizoxime and vancomycin were all 100%. The sensibility rate, mesomerism rate and resistant rate of GAS to levofloxacin and ofloxacin were 94%, 6% and 0%, respectively. The sensibility rate, mesomerism rate and resistant rate of GAS to clindamycin was 8%, 4% and 88%, respectively. The resistant rate of GAS to erythromycin was 100%. Conclusions Pathogenic bacteria GAS of scarlet fever patients in Jinan of Shandong Province has high resistance to macroeyclic laetone antibiotics and has high sensibility to penicillins, cephem antibiotics and quinolone antibacterials. Penicillins are still choice drugs in treating scarlet fever.