Khai Quang Tran, Thuy Thi Dieu Nguyen, Van Hung Pham, Quan Minh Pham, Hung Do Tran
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引用次数: 0
摘要
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越来越受到关注。本研究旨在确定导致儿童重症 CAP 的 MRSA 菌株分离率,并评估其抗生素耐药性水平。研究采用横断面设计。对患有严重 CAP 的儿童进行鼻咽抽吸取样,以培养、分离和鉴定 MRSA。采用梯度扩散法进行抗菌药敏感性测试,以确定抗生素的最小抑菌浓度(MIC)。结果:MRSA被确定为越南儿童严重CAP的第二大病因。金黄色葡萄球菌分离率为 41/239(17.5%),其中大部分为 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较强,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,对万古霉素(0.5 毫克/升)的 MIC90 降低了 32 倍,对利奈唑胺(4 毫克/升)的 MIC90 降低了 2 倍。因此,万古霉素和利奈唑胺可能是 MRSA 确定的重症 CAP 的适当选择。
Pathogenic Role and Antibiotic Resistance of Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Causing Severe Community-Acquired Pneumonia in Vietnamese Children.
In recent years, the pathogenic role and antibiotic resistance of methicillin-resistant Staphylococcus aureus (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 S. aureus 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 MIC90 for vancomycin (0.5 mg/L) and a 2-fold decreased MIC90 for linezolid (4 mg/L). Therefore, vancomycin and linezolid may be appropriate options for severe CAP identified by MRSA.
期刊介绍:
"Advances in Respiratory Medicine" is a new international title for "Pneumonologia i Alergologia Polska", edited bimonthly and addressed to respiratory professionals. The Journal contains peer-reviewed original research papers, short communications, case-reports, recommendations of the Polish Respiratory Society concerning the diagnosis and treatment of lung diseases, editorials, postgraduate education articles, letters and book reviews in the field of pneumonology, allergology, oncology, immunology and infectious diseases. "Advances in Respiratory Medicine" is an open access, official journal of Polish Society of Lung Diseases, Polish Society of Allergology and National Research Institute of Tuberculosis and Lung Diseases.