Zheng Xiao-Yu, Choy Bonnie Nga Kwan, Zhou Ming-Ming, Zhao Zheng-Yan
Department of Ophthalmology, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Ophthalmology, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Front Pediatr. 2021 Nov 19;9:728634. doi: 10.3389/fped.2021.728634. eCollection 2021.
() is an important pathogen of ocular infections in pediatrics. The study aimed to identify the prevalence and resistance pattern of , especially methicillin-resistant (MRSA), in Chinese children with ocular infections. All patients with infections were reviewed at a tertiary children's hospital during 2015-2020, and those with ocular infections were investigated for susceptibility results. Of 1,668 strains, there were 177 unique isolates from ocular infection. Among them, 45 (25.4%) were MRSA and 132 (74.6%) were methicillin-sensitive (MSSA). The proportion of MRSA did not change over time. Most of the strains were obtained from the neonate ward and ophthalmology department ( = 88, 49.7%, and = 85, 48.0%, respectively), while eye secretion and pus were the main specimen types ( = 128, 72.3%, and = 37, 20.9%, respectively). MRSA was significantly resistant against penicillin class (97.8%), erythromycin (71.1%), clindamycin (71.1%), and tetracycline (32.1%), with a high multidrug resistance (MDR) rate of 71.1%. However, MRSA was highly sensitive to levofloxacin. Resistance rates against erythromycin and ciprofloxacin as well as MDR percentage all increased among MSSA in children above 1 year of age, ophthalmology department, and outpatient population and decreased in eye secretion specimen. The mean resistance percentage remained stable for MRSA and MSSA during the study period. The survey of ocular pathogens in pediatrics and their antibiotic resistance patterns helps in clinical treatment. MRSA with many strains demonstrating MDR is highly prevalent in children with ocular infections in Southeast China. Levofloxacin is an effective topical antibiotic for ocular MRSA infection, while erythromycin has a high resistance rate. The antibiotic resistance patterns of MRSA and MSSA differs and varies by different stratifications. A cautious use of antibiotics should be considered.
（）是儿科眼部感染的重要病原体。本研究旨在确定中国眼部感染儿童中（）的流行情况和耐药模式，尤其是耐甲氧西林（）。2015年至2020年期间，在一家三级儿童医院对所有（）感染患者进行了回顾，对眼部感染患者的药敏结果进行了调查。在1668株（）菌株中，有177株来自眼部感染的独特分离株。其中，45株（25.4%）为耐甲氧西林（），132株（74.6%）为甲氧西林敏感（）。耐甲氧西林（）的比例未随时间变化。大多数菌株来自新生儿病房和眼科（分别为88株，49.7%，和85株，48.0%），而眼分泌物和脓液是主要标本类型（分别为128株，72.3%，和37株，20.9%）。耐甲氧西林（）对青霉素类（97.8%）、红霉素（71.1%）、克林霉素（71.1%）和四环素（32.1%）具有显著耐药性，多重耐药（）率高达71.1%。然而，耐甲氧西林（）对左氧氟沙星高度敏感。1岁以上儿童、眼科和门诊患者中，甲氧西林敏感（）对红霉素和环丙沙星的耐药率以及多重耐药百分比均有所增加，而在眼分泌物标本中则有所下降。在研究期间，耐甲氧西林（）和甲氧西林敏感（）的平均耐药百分比保持稳定。对儿科眼部（）病原体及其抗生素耐药模式的调查有助于临床治疗。耐甲氧西林（）在东南部地区眼部感染儿童中高度流行，许多菌株表现出多重耐药。左氧氟沙星是治疗眼部耐甲氧西林（）感染的有效局部抗生素，而红霉素耐药率较高。耐甲氧西林（）和甲氧西林敏感（）的抗生素耐药模式不同，且因不同分层而异。应考虑谨慎使用抗生素。
