儿童呼吸道感染常见革兰阳性致病菌耐药性研究

目的 研究儿科患者呼吸道感染常见致病菌(肺炎链球菌、金黄色葡萄球菌及A族乙型溶血性链球菌)的耐药情况.方法 对2004年1月至2006年12月首都医科大学附属北京友谊医院儿科呼吸道感染患儿鼻咽分泌物分离的55株金黄色葡萄球菌、49株肺炎链球菌、15株A族乙型溶血性链球菌采用K-B纸片法进行抗生素敏感性检测.结果 49株肺炎链球菌对红霉索的耐药率高达90%,青霉素不敏感株5株,占10%,多重耐药率高达90%;55株金黄色葡萄球菌对氨苄西林耐药率为86%,对青霉素耐药率为82%,对苯唑西林耐药率为9%,且多重耐药问题很严重;15株A族乙型溶血性链球菌对红霉素的耐药率为80%,对青霉素和氨苄西林敏感.结论 儿童呼吸道感染常见致病菌的耐药情况不容乐观.肺炎链球菌及A族乙型溶血性链球菌对红霉素的耐药性很高;发现了耐甲氧西林的金黄色葡萄球菌,且多重耐药问题很严重.儿童呼吸道细菌感染时,应尽量避免使用非β-内酰胺类抗生素.

Antimicrobial resistance of gram-positive pathogenic bacteria isolated from children's respiratory tract infection

Objective To investigate antirnierobial resistance of comlnon pathogenic bacteria isolated from children's respiratory tract in Beijng friendship Hospital during the period between January 2004 and December 2006.Methods Forty-nine strains of Streptococcus pneumoniae,fifty-five strains of Staphylococcus aureus and fifteen strains of Group A β-hemolytic streptococcus were isolated from children with community-acquired respiratory tract infeetion in pediatric department of Beijng Friendship Hospital.Kirby-Bauer agar dilution method Was used to determine the susceptibility to antimicrobial agents.Results Ninety percent of Streptococcus pneumoniae strains were resistant to erythromycin.Penicillin-non-susceptible streptococcus pneumoniae accounted for 10%,while 90% of which were multi-drug resistant.For Staphylococcus aureu strains,the resistant rates of ampicillin,penicillin and oxacfllin were 86%,82%,and 9% respectively,and serere multi-drug resistance was found.Eighty percent of the group A β-hemolytic streptococcus strains were resistant to erythromycin,however all remained sensitive to penicillin and ampicillin.Conclusion The antimicrobials resistant pathogenic bacteria isolated from children with respiratory tract infection have become a severe prdblem.The resistant rates of macrolides are high for Streptococcus and Group A β-hemolytic streptococcus.MeticiUin resistant staphylococcus aureus(MRSA)strains were found in the study.Severe multi-drug resistance was found.Non β-lactam antibiotics should be avoided when respiratory tract bacterial infection occurred in children.