中国实用儿科杂志

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新生儿金黄色葡萄球菌感染临床特点菌株耐药表型和mecA基因检测

华春珍,俞惠民   

  1. 浙江大学医学院附属儿童医院,浙江杭州310003;第一作者现在杭州师范学院临床医学院儿科工作
  • 收稿日期:2006-01-10 修回日期:2006-06-15 出版日期:2006-09-06 发布日期:2006-09-06

Analysis of 35 neonates with infection caused by staphylococcus aureus and investigation on antibioticresistance and mecA gene of those strains.

Hua Chunzhen, Yu Huimin.   

  1. Children's Hospital,School of Medicine, Zhejiang University , Hangzhou 310003,China.
  • Received:2006-01-10 Revised:2006-06-15 Online:2006-09-06 Published:2006-09-06

摘要: 目的了解新生儿金黄色葡萄球菌(金葡菌)感染的临床特点及其菌株表型。 方法对200402—200506受金葡菌感染的新生儿进行临床资料分析,并用纸片扩散法完成12种常用抗生素的药敏试验,同时用Etest法进行苯唑西林和万古霉素耐药性检测,并对所有菌株采用PCR技术检测mecA基因。 结果金葡菌感染的新生儿共35例,年龄为6~28d,男性21例,女性14例。35例感染儿包括肺炎24例,败血症7例,皮下坏疽2例,皮肤蜂窝织炎伴脓肿形成1例,脐炎1例。药敏结果显示97.1%的菌株产生β内酰胺酶而对青霉素G耐药,82.9%的菌株对苯唑西林敏感,MIC50和MIC90分别为0.5μg/mL和4.0μg/mL;对头孢噻肟和头孢曲松的敏感率均为82.9%;对红霉素、四环素、克林霉素、甲氧苄啶磺胺甲基异口恶唑、氧氟沙星和氯霉素的耐药率分别为54.3%、37.1%、17.1%、14.3%、5.7%和2.9%;所有菌株均对万古霉素和利福平敏感。MecAPCR结果显示:6株耐苯唑西林株mecA基因均阳性,而标准株ATCC25923和所有敏感株均阴性。 结论新生儿金葡菌感染以呼吸道感染为主,该菌对苯唑西林的耐药率不高。

Abstract: AbstractObjectiveTo analyze the clinical manifestation of newborns with infection caused by staphylococcus aureus (S. aureus) and investigate the antibioticresistance phenotype of these strains. MethodsS. aureus isolates were identified with GPI card of Vitek system. Antibiotics sensitivity test were performed by using disk diffusion methods,and sensitivity test of oxacillin and vancomycin was performed with a further Etest method.The mecA gene was detected with PCR. ResultsThirtyfive neonates (21 males and 14 females) with infection caused by staphylococcus aureus were identified, aged from 6d to 28d,including 24 cases of pneumonia, 7 cases of septicaemia, 2 cases of hypodermic gangrene, 1 case of phlegmona with formation of an abscess and 1 case of omphalitis. Drug susceptibility test showed that 97.1% of 35 strains were βlactamasepositive and resistant to penicillin, while 82.9% of all strains were sensitive to oxacillin with MIC50 0.5 μg/m and MIC90 4.0 μg/mL. All strains were sensitive to vacomycin and rifampin , while 82.9% of all strains were susceptible to cefotaxime and ceftriaxone. Resistance rates to erythromycin, tetracycline, clindamycin, trimethoprimsulfamethoxazole, ofloxacin and chloramphenicol were 54.3%, 37.1%, 17.1%, 14.3%, 5.7% and 2.9% respectively.The mecAPCR showed that the control strain ATCC25923 and all oxacillinsensitive S. aureus were mecAnegative ,while 6 oxacillinresistant strains were mecApositive. ConclusionLow respiratory tract infection is the most common disease in all infections caused by S. aureus in newborn children and most of them are community acquired.