北京地区儿童皮肤感染金黄色葡萄球菌的耐药研究

目的 分析儿童皮肤感染金黄色葡萄球菌的耐药现状及社区获得性耐甲氧西林金黄色葡萄球菌的流行情况。方法 对600例感染性皮肤病患儿皮损分泌物进行细菌培养。应用琼脂稀释法检测抗生素及环丙沙星对培养出的金黄色葡萄球菌的最小抑菌浓度。结果 600例患儿皮损共培养出金黄色葡萄球菌451株，对13种抗生素及环丙沙星的药敏试验结果显示，对青霉素耐药率为93.8%，对红霉素耐药率为87.6%，对克林霉素为71.6%，对四环素、氯霉素、庆大霉素和环丙沙星的耐药率依次为37.3%，13.3%，6.4%和2.2%，对苯唑西林、头孢唑啉、头孢呋辛和莫匹罗星耐药率分别为1.6%，0.4%，0.2%和0.2%，未发现头孢曲松、万古霉素和夫西地酸耐药菌株。结论 儿童社区获得性耐甲氧西林金黄色葡萄球菌分离率为1.6%。治疗社区来源的皮肤金黄色葡萄球菌感染性皮肤病，全身治疗首选耐青霉素酶的半合成青霉素和头孢菌素，外用治疗可选择莫匹罗星或夫西地酸。

Antimicrobial susceptibility of Staphylococcus aureus isolated from children with infectious skin diseases in Beijing area

Objective To study the antimicrobial susceptibility of Staphylococcus aureus isolated from children with infectious skin diseases in Beijing area and to investigate the prevalance of community acquired methicillin-resistant S.aureus (MRSA).Methods S.aureus was isolated from 600 outpatients with infectious skin diseases in Beijing Children's ospital.The susceptibility of these isolates to 14 antimi crobial agents was determined by agar dilution method according to the guidelines from Clinical and Laboratory Standards Institute (CLSI).Results Totally，451 S.aureus strains were isolated.Of them,93.8% were resistant to penicillin,87.6% to erythromycin,71.6% to lindamycin,37.3% to etracycline,13.3% to chloramphenicol,6.4% to gentamicin,1.6%to oxacillin,2.2% to ciprofloxacin,0.4% to cefazolin,0.2% to cefuroxime and mupirocin.No resistance was found to vancomycin,ceffriaxone or fusidic acid.Conclusions The results suggest that penicillin and erythromycin are no longer the appropriate agents for the treatment of S.aureus.The prevalance of MRSA iS 1.6% in children with infectious skin diseases in Beijing area.Oxacillin and cephalosporin are recommended for systemic treatment of community acquired MRSA,and mupirocin or fusidic acid for its topical treatment.