摘要
目的探讨我国部分地区学龄儿童Ａ组溶血性链球菌（ＧＡＳ）对抗生素耐药的流行状况。方法采用ＶＩＴＥＫ自动微生物鉴定系统，测试３７６株从９～１岁学龄儿童咽部分离出的ＧＡＳ，吉林９７株、湖北８４株、四川８１株、广州农村６２株、广州城市５２株。结果四省总耐药率６７．３％，主要耐药依次为四环素６５．７％、红霉素４３．３％、氯林可霉素３４．０％、氯霉素６．９％、氨苄青霉素０．５％，未发现对青霉素、头孢噻吩、喹诺酮类药物耐药的菌株。不同地区间耐药率存在差异（Ｐ＜０．００５），吉林最高达９４．８％，依次为广州农村８３．８％、重庆５８．０％、湖北５０．０％、广州城市３８．５％。结论目前治疗ＧＡＳ感染和风湿热一、二级预防不宜使用红霉素和氯林可霉素；ＧＡＳ感染仍首选青霉素。
Objective To explore the antibiotic resistance epidemiological status of group A streptococci (GAS) isolated from school children in different regions of China. Methods From September 1993 to August 1994, 376 GAS isolates were collected from 9～11 years old healthy school children in 4 provinces of China. The authors tested 97, 81, 84, 62 and 52 isolates of GAS from Jilin province, Northeast China, Sichuan province, Southwest China, Hubei province, Central China, Guangdong province, South China, and rural and urban areas of Guangzhou, respectively for minimum inhibitory concentration (MIC) to 10 kinds of antibiotics with microdilution method. Results (1) All 376 isolates were exquisitely susceptible to penicillin G, cephalothin, nitrofurantoin, norfloxacin, gentamycin and streptomycin. (2) An overall resistance rate was 67.3% in all 376 isolates. The resistance rates were 65.7% to tetracycline, 43.3% to erythromycin, 34.0% to clindamycin, 6.9% to chloramphenicol, 0.5% to ampicillin. There was obviously statistical difference in drug resistance rates to 5 kinds of antibiotics ( P <0.005). (3) There was statistically significant difference ( P <0.005) for the overall drug resistance rates among the 5 areas, which were 94.8% for Jilin province, 83.8% for Guangzhou rural, 58.0% for Chongqing, 50.0% for Hubei, 38.5% for Guangzhou urban, respectively. (4) Multiresistance isolates to tetracycline, erythromycin and chloramphenicol reached 76.3% in Jilin province. Conclusions Penicillin G is still the first choice for the treatment of GAS infections. Beta lactams and quinolones are acceptable alternatives in penicillin allergic individuals. Tetracycline, erythromycin and chloramphenicol are not recommended for treatment of GAS infections and primary or secondery prevention of rheumatic fever at present.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
1999年第1期35-37,共3页
Chinese Journal of Pediatrics
关键词
链球菌
抗生素
抗药性
GAS
Streptococcus, pyogenes Antibiotics Drug resistance
