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《Chinese Journal of Evidence-Based Pediatrics》 2006-02
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Susceptibility of Gram-positive bacteria to antimicrobial drugs among pediatric patients in China: an analysis of hospital data from Beijing, Shanghai, Guangzhou and Chongqing 2000-2004

WANG Ling ,LU Quan, WANG Chuan-qing , DENG Qiu-lian, LIU Lan, ZHEN Jing-hui, ZHANG Hong, WANG Yi , HUANG Yong, CHEN Yuan, YANG Yong-hong, SHEN Xu-zhuang (Children's Hospital of Capital University of Medical Sciences, BeijingA 100045;Children's Hospital of Jiaotong University, Shanghai 200040;Children 's Hospital of Fudan University, Shanghai 200032;Guangzhou Children's Hospital, Guangzhou 510120; Children's Hospital Affiliated to Chongqing University, Chongqing 400014)  
Objective To investigate the drug-resistance rate of gram-positive cocci isolated from petients in 5 pediatric hospitals located in different areas in China. Methods From Jan 1st 2000 to Dec 31st 2004,a total of four types pathogenic strains was isolated from 5 pediatric hospitals which were Beijing Children's Hospital, Children's Hospital of Fudan University, Shanghai Children's Hospital, Guangzhou Children's Hospital and Chongqing Children's Hospital. 8215 isolates were from hospital acquired infection( HAI) and community acquired infection (CAI). The all 8215 strains were tested by Kirby-Bauer method. According to the criteria of guidelines of NCCLS in each year from 2000 to 2004, the persentage of resistance as the resistance and intermediate, and the percentage of susceptabilily rate of bacteria to the compound tested. We chose Penicillin, Oxacillin, Amoxicillin and Clavulanat, Clindamycin, Cefuroxime , Ceftriaxone , Erythromycin, Compound Sulfamethoxazole and Vancomycin to test Streptococcus aureus; Penicillin, Erythromycin , Clindamycin, Vancomycin, Ofloxacin and Compound Sulfamethoxazole test Streptococcus pneumoniae; Penicillin, Erythromycin, Clindamycin, Vancomycin and Ofloxacin to test Streptococci hemolyticus; Ampicillin, Streptomycin ( high concentration) , Gentamycin ( high concentration, Ciprofloxacin, Vancomycin, Teicoplanin, Erythromycin and Rifampicin to test Enterococcus. Results Among a total of 4004 strains of Streptococcus aureus, the detectable rates of methicilin-resistantce in Staphylococcus aureus(MRSA) was 7. 15% , the rate of resistance to erythromycin was increased to 61. 96%. The rate of MRSA from two the hospitals in Shanghai was higher than the others. All Streptococcus aureus isolates were susceptible to vancomycin. 2 402 strains of S. pneumoniae were isolated. The rate of penicillin unsusceptible Streptococcus pneumoniae (PRSP) was 63.42% , and the rate of resistance to erythromycin was 86. 22% ; The total strains of 432 streptococci hemolyticus were all susceptible to penicillin, while the rate of resistance to erythromycin was 68. 47% which was rising year by year. The rate of erythromycin- resistant were various from 37.73% to 100% by area; 2. 73% from all 1377 isolated Enterococcus strains was found intermediate to vancomycin,and the rate of ampicillin resistant was 51.91%. We found that all the vancomycin-intermediate Enterococcus were from Shanghai. The rate of resistance to erythromycin was 88. 10%. Conclusions Except streptococci hemolyticus, G+ coccus showed a high resistant rate to penicillin; almost all G+ coccus were susceptible to vancomycin and teicomycin, and resistant to erythromycin with a trend of rising. MRSA was low in rate,and we havent find VRSA and VISA. There was 2.73% of Enterococcus intermediate to vancomycin and more attention should be payed to it. Antimicrobial resistant coccus in pediatric has already become a serious problem in China. Ongoing surveillance for antimicrobial resistance of gram-positive coccus is necessary for the appropriate antimicrobial use in pediatric clinical practice.
【Fund】: 国家科技部十五攻关项目资助(2004BA720A09-01)
【CateGory Index】: R446.5
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