摘要
目的了解儿童鼻咽部带菌状况,为疾病预防和治疗提供科学依据。方法对2所幼儿园186名儿童的鼻咽拭子进行培养、分离、鉴定及药敏试验,按《全国临床检验操作规程》进行。药敏试验根据1999年美国NCCLS有关抗生素敏感试验标准进行,流感嗜血杆菌β-内酰胺酶检测采用N itrocefin纸片法,耐青霉素肺炎链球菌(PRP)检测采用E-test法。结果186份标本共分离出374株细菌,其中同时分离出3株细菌的有45份(占24.2%),同时分离出2株细菌的有98份(占52.7%),仅分离到1株菌的有43份(占23.1%)。以副流感嗜血杆菌、肺炎链球菌、假白喉棒状杆菌、流感嗜血杆菌、草绿色链球菌、表皮葡萄球菌和金黄色葡萄球菌为主,分别占50.5%、32.8%、28.0%、24.2%、17.7%、15.6%和11.3%。94株副流感嗜血杆菌β-内酰胺酶试验阳性3株(占3.2%),45株流感嗜血杆菌β-内酰胺酶试验阳性2株(占4.4%),21株金黄色葡萄球菌β-内酰胺酶试验阳性18株(占85.7%)。61株肺炎链球菌耐青霉素13株占21.3%,多重耐药株(同时耐3种或3种以上菌株)占21.3%,对红霉素、四环素、氯霉素、克林霉素、利福平、氧氟沙星、头孢噻肟、复方新诺明和万古霉素的耐药率分别为67.2%、52.5%、47.5%、52.7%、31.1%、1.6%、4.9%、67.2%和0;21株金黄色葡萄球菌耐苯唑西林5株(占23.8%)。结论调查结果显示,健康儿童鼻咽部寄生菌谱较为宽广,而临床上引起小儿呼吸道感染的主要致病菌,如肺炎链球菌、流感嗜血杆菌和金黄色葡萄球菌,分别占第2、第4和第7位,这一结果提示儿童鼻咽部带菌状况与小儿呼吸道感染有一定关系。不同性别儿童主要细菌检出率比较差异无显著性。耐青霉素肺炎链球菌已处于较高水平,其对常用抗生素普遍耐药,且已发现对3代头孢菌素耐药菌株,可能引起流行病,值得政府有关部门、疾病预防工作者和临床医生的关注。
Objective To determine the prevalence of healthy bacteria carriers in children. Methods Oropharyngeal swabs were collected with a cotton tipped swab in an Amics transport medium and cultured on Thayer Martin plates and blood agar plates at 35 ℃ in 18% CO2 by （native clinical laboratory technology rule）. All isolates of S. pneumoniae were tested for antimicrobial susceptibility to penicillin, cefotaxime, erythromycin, tetracycline, chlormphenicol, clindamycin, ofloxacin,rifampin,vancomycin and trimethoprim-sulfamiethoxazole. Results Of the 186 children studied,bacteria nasopharyngeal carriage rates were as follows ： Haemophilus parainfluenzae ,50. 5 % ;Streptococcus Pneumoniae carriers, 32. 8% ; Corynebacterium pseudodiphtheriticum carriers, 28. 0% ; Haemophilu influenzae,2 4. 2%. Aerococcus viridaas, 17.7 % ;Staphylococcus epidermidis, 15.6% ; Staphylococcus aureus, 11.3%. Streptococcus Prveumoniae resistance rates were as follows ： penicillin, 21.3% （ 18. 0% intermediate ; 3.3% resistant） ; erythromycin, 67.2% ; tetracycline, 52.5% ; chloramphenicol, 47.5% ; clindamycin,52. 7% ; cefotaxime, 4.9% ; rifampin, 31, 1% ; ofloxacin, 1.6% ; vancomycin, 0% and trimethoprim-sulfamiethoxazole ,67.2%. Conclusions The prevalence of healthy carriers of bacteria in children was broad. There were no staffstically significant differences among the different children sex groups. These data showed that carriage of antibiotic-resistant pneumococcal was high in zhongshan city. All strains were susceptible to vancomycin.
出处
《中国微生态学杂志》
CAS
CSCD
2006年第3期204-205,208,共3页
Chinese Journal of Microecology
基金
中山市医学科研基金项目(项目编号:2002-28)
关键词
儿童
鼻咽部
细菌
携带率
耐药性
Pediatrics
Bacteria
Carrier state
Resistance
作者简介
罗小铭（1970-），男，副主任技师，从事疾病预防检测工作。
