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目的对贵州两县急性肾小球肾炎暴发相关A组链球菌(group A streptococcus,GAS)进行抗生素耐药性分析,探讨耐药监测在GAS疫情处理与控制中的作用。方法采用E-test法测定GAS对8种抗生素(氨苄青霉素、头孢曲松、万古霉素、红霉素、四环素、左氧氟沙星、氯霉素、克林霉素)的敏感性。结果68株GAS对红霉素和四环素的耐药率分别为88.2%和97.1%。不同人群、不同学校来源菌株对抗生素的敏感性无统计学差异(P>0.05)。结论健康携带者与患者分离菌株间抗生素耐药性的一致性提示对自然人携带GAS的耐药监测对疾病控制与疫情处理的重要性;当地治疗GAS感染不宜使用红霉素,青霉素仍为治疗GAS感染的首选药物,对青霉素过敏者可选头孢菌素类抗生素替代。
Objective To analyze the antibiotic resistance of group A streptococcus (GAS) related to the outbreak of acute glomerulonephritis in two counties of Guizhou province and explore the role of drug resistance monitoring in the treatment and control of GAS epidemic. Methods The sensitivity of GAS to eight antibiotics (ampicillin, ceftriaxone, vancomycin, erythromycin, tetracycline, levofloxacin, chloramphenicol and clindamycin) was determined by E-test. Results The resistance rates of 68 GAS to erythromycin and tetracycline were 88.2% and 97.1%, respectively. There was no significant difference in antibiotic susceptibility between different populations and different schools (P> 0.05). Conclusions The consistency of antibiotic resistance among isolates of healthy carriers and patients suggests that the surveillance of resistance to GAS carried by natural persons is of importance for disease control and epidemic treatment. Erythromycin should not be used for local treatment of GAS infection, and penicillin is still the treatment of GAS The drug of choice for infection, allergic to penicillin alternative cephalosporin antibiotics alternative.