小儿表皮葡萄球菌败血症临床特点及近十年药敏变迁

目的研究小儿表皮葡萄球菌败血症(SES)的临床特点及近十年药敏变迁。方法回顾性分析1995年1月至2004年12月经血培养证实的72例表皮葡萄球菌败血症患儿的住院临床资料,分前、后5年两个阶段对表皮葡萄球菌(SE)药敏结果进行对比分析。结果近几年小儿SES发生率有上升趋势,常见于1岁以内婴儿(占87.5%),尤其是新生儿(占68.06%);脐部及皮肤感染是引起发病的主要途径;前后5年间该菌对多种常用抗生素耐药率发生显著变化(P<0.05),但尚未发现对万古霉素耐药菌株。结论SES在小儿发病率有增高趋势,近五年对多种常用抗生素耐药率显著增高,对疑诊患儿应及早做血培养并根据药敏选用有效抗生素,对常用抗生素无效者可选用万古霉素。

Clinical feature of staphylococcus epidermidis septicemia in children and transition of drug sensitivity results in recent ten years

Objective To investigate both of the clinical features of staphylococcus epidermidis septicemia (SES) in children and the recent ten,year transition in the sensitivity of staphylococcus epidermidis (SE) to antibiotics. MethodsSeventy,two children with SES verified by germiculture were reviewed from Jan 1995 to Dec 2004,and the data of drug sensitivity test were compared between the former 5,year group and the latter 5,year group. Results There was an increas,ing trend in the incidence of SES in children recent years. SES was commonly occurred in infants within 1 year of age (accounting for 87.5 %) in particular in newborn infants (68.06 %). The primary route of infection was through omphalitis or infective skin. The drug, resistence rates of SE to penicillin,ampicillin,oxacillin,cefpriamide,ceftriaxone and tienam changed significantly in the latter 5 years compared to those in the former 5 years (P <0.05 for all). However,all SE samples were sensitive to vancomycin. Conclusions The incidence of SES in children increases recent years and the resistance of SE to ordinary antibiotics is very common. It is suggested that blood germiculture need to do earlier and the effective antibiotics can be chosen based on the drug sensitivity test. Vancomycin shall be helpful when ordinary antibiotics used are inefficacy.