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[从儿童鼻咽部分离出的肺炎链球菌和流感嗜血杆菌中的抗菌药物耐药性]

[Antimicrobial resistance in Streptococcus pneumoniae and Haemophilus influenzae isolated from nasopharynx in children].

作者信息

Matsumoto Ayumi, Hosoya Mitsuoki, Katayose Masahiko, Murai Hiromichi, Kawasaki Yukihiko, Sato Kei, Kato Kazuo, Suzuki Hitoshi

机构信息

Department of Pediatrics, Soma General Hospital.

出版信息

Kansenshogaku Zasshi. 2004 Jun;78(6):482-9. doi: 10.11150/kansenshogakuzasshi1970.78.482.

Abstract

The aims of this study are to investigate the antimicrobial susceptibility of bacteria isolated from children and clarify the risk factors for the carriage of the resistant strains. We examined the minimum inhibitory concentrations (MICs) of antimicrobial agents against 949 strains of Streptococcus pneumoniae (S. pneumoniae) and 791 strains of Haemophilus influenzae (H. influenzae) isolated at our department between September, 2001 and May, 2003. Of those, 226 S. pneumoniae strains and 115 H. influenzae strains were analysed for the resistance genes. Also we retrospectively reviewed the profiles of 1,359 patients with either S. pneumoniae, H. influenzae, or both in nasopharynx. From the view point of MICs, PSSP strains were 185 (19%), PISP strains were 443 (47%), and PRSP strains were 321 (34%) in 949 S. pneumoniae strains, and BLNAS strains were 545 (69%), low-BLNAR strains were 104 (13%), BLNAR strains were 81 (11%), and BLPAR strains were 61 (8%) in 791 H. influenzae strains. The results of gene analysis showed that all resistant strains by MICs such as PISP, PRSP, BLNAR, and BLPAR had resistant genes and that 55% of and 21% of susceptible strains of S. pneumoniae (PSSP) and H. influenzae (BLNAS), respectively, had resistant genes. From the investigation for profiles of 1,359 patients, age less than 3 years old, day nursery, and use of antimicrobial agents in last 3 month, seemed to be the risk factors for carriage of resistant strains. To prevent the resistant bacteria from disseminating we should re-consider how to use the antimicobial agents and nurse the young children.

摘要

本研究旨在调查从儿童中分离出的细菌的抗菌药敏情况,并阐明携带耐药菌株的危险因素。我们检测了2001年9月至2003年5月间在我科分离出的949株肺炎链球菌和791株流感嗜血杆菌对抗菌药物的最低抑菌浓度(MIC)。其中,对226株肺炎链球菌和115株流感嗜血杆菌进行了耐药基因分析。此外,我们回顾性分析了1359例鼻咽部携带肺炎链球菌、流感嗜血杆菌或两者的患者资料。从MIC角度来看,949株肺炎链球菌中,青霉素敏感肺炎链球菌(PSSP)菌株有185株(19%),青霉素中介肺炎链球菌(PISP)菌株有443株(47%),青霉素耐药肺炎链球菌(PRSP)菌株有321株(34%);791株流感嗜血杆菌中,β-内酰胺酶阴性氨苄西林耐药(BLNAS)菌株有545株(69%),低β-内酰胺酶阴性氨苄西林耐药(low-BLNAR)菌株有104株(13%),β-内酰胺酶阳性氨苄西林耐药(BLNAR)菌株有81株(11%),β-内酰胺酶阳性氨苄西林部分耐药(BLPAR)菌株有61株(8%)。基因分析结果显示,所有经MIC检测为耐药的菌株如PISP、PRSP、BLNAR和BLPAR均有耐药基因,而肺炎链球菌(PSSP)和流感嗜血杆菌(BLNAS)的敏感菌株中分别有55%和21%有耐药基因。通过对1359例患者资料的调查,年龄小于3岁、日托以及过去3个月内使用抗菌药物似乎是携带耐药菌株的危险因素。为防止耐药菌传播,我们应重新考虑抗菌药物的使用方式并做好幼儿护理工作。

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