Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 90000, Vietnam.
Department of Pediatrics, Hanoi Medical University, Hanoi 100000, Vietnam.
Adv Respir Med. 2023 Mar 30;91(2):135-145. doi: 10.3390/arm91020012.
In recent years, the pathogenic role and antibiotic resistance of methicillin-resistant (MRSA) strains causing severe community-acquired pneumonia (CAP) have received increasing attention in clinical practice. The aim of this study was to determine the rate of isolates of MRSA strains causing severe CAP in children and to assess their level of antibiotic resistance. The study design was cross-sectional. Children with severe CAP were sampled by nasopharyngeal aspiration for the culture, isolation, and identification of MRSA. Antimicrobial susceptibility testing was performed using the gradient diffusion method to determine the minimum inhibitory concentration (MIC) of antibiotics. Results: MRSA was identified as the second leading cause of severe CAP in Vietnamese children. The rate of isolates of was 41/239 (17.5%), of which most were MRSA, at 32/41 (78.0%). MRSA strains were completely non-susceptible to penicillin (100%), more resistant to clindamycin and erythromycin, less sensitive to ciprofloxacin and levofloxacin, and fully susceptible to vancomycin and linezolid, with a 32-fold decreased MIC for vancomycin (0.5 mg/L) and a 2-fold decreased MIC for linezolid (4 mg/L). Therefore, vancomycin and linezolid may be appropriate options for severe CAP identified by MRSA.
近年来，引起严重社区获得性肺炎（CAP）的耐甲氧西林金黄色葡萄球菌（MRSA）菌株的致病作用和抗生素耐药性在临床实践中受到越来越多的关注。本研究旨在确定引起儿童严重 CAP 的 MRSA 菌株的分离率，并评估其抗生素耐药水平。研究设计为横断面研究。通过鼻咽抽吸对严重 CAP 患儿进行采样，进行 MRSA 的培养、分离和鉴定。采用梯度扩散法进行药敏试验，以确定抗生素的最小抑菌浓度（MIC）。结果：MRSA 是越南儿童严重 CAP 的第二大主要病因。MRSA 的分离率为 41/239（17.5%），其中大多数为 MRSA，为 32/41（78.0%）。MRSA 菌株对青霉素完全不敏感（100%），对克林霉素和红霉素的耐药性更高，对环丙沙星和左氧氟沙星的敏感性较低，对万古霉素和利奈唑胺完全敏感，万古霉素的 MIC 降低了 32 倍（0.5mg/L），利奈唑胺的 MIC 降低了 2 倍（4mg/L）。因此，万古霉素和利奈唑胺可能是由 MRSA 引起的严重 CAP 的合适选择。
