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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。
Objective To understand the clinical features of neonatal Staphylococcus aureus (Staphylococcus aureus) infection and its strain phenotype. Methods The clinical data of neonates infected with Staphylococcus aureus from February 2004 to June 2005 were analyzed. The antibiotic susceptibility tests of 12 commonly used antibiotics were completed by disk diffusion method. Meanwhile, oxacillin and vancomycin Superoxide dismutase resistance assay was used to detect mecA gene in all strains. Results Staphylococcus aureus infection in 35 newborns, aged 6 ~ 28d, 21 males and 14 females. 35 cases of infection, including pneumonia in 24 cases, sepsis in 7 cases, 2 cases of subcutaneous gangrene, skin cellulitis with abscess formation in 1 case, 1 case of omphalitis. The susceptibility results showed that 97.1% strains produced β-lactamase and were resistant to penicillin G, 82.9% strains were susceptible to oxacillin, with MIC50 and MIC90 of 0.5 μg / mL and 4.0 μg / mL, respectively ; The susceptibility to cefotaxime and ceftriaxone were 82.9%; erythromycin, tetracycline, clindamycin, trimethoprim - sulfamethoxazole, ofloxacin and chlorine The resistance rate of the strains was 54.3%, 37.1%, 17.1%, 14.3%, 5.7% and 2.9% respectively. All the strains were sensitive to vancomycin and rifampicin . MecA-PCR results showed that all of the 6 isolates of oxacillin-resistant mecA gene were positive, while the standard strain ATCC25923 and all the sensitive strains were negative. Conclusion The neonatal Staphylococcus aureus infection is mainly respiratory tract infection. The resistance rate of oxacillin to this bacterium is not high.