Investigation On Antibiotic Use In Children And Detection On Drug-resistance Of Staphylococcus In ShenYang

Bacteria infection were always the one of the common diseases, along with antibiotic abuse, more and more drug-resistance bacterial have been quickly disseminated, it had made great trouble to treat pediatrics infectious diseases. It is significant to guide rational use antibiotic by getting the status of antibiotic use in children, investigating distribution of clinical pathogenic bacterium and resistant feature.ObjectThe purpose is to survey the pediatrics antibiotic use condition of Liao Ning province people's hospital, monitor the epidemic distribution of pathogenic bacterium and detect drug-resistance condition of coagulase negative staphylococcus, guide rational antibiotic us. The other purpose is to carry out drug sensitivity test for analyzing drug-resistance status, initially research resistance mechanism of bacteria.MethodCollect randomly 301 pediatric infectious hospitalize case files from January 2004 to November 2005 and make statistical analysis for antibiotic use condition. Isolate bacteria from samples and analyze distribution. The method of detecting coagulase negative staphylococcus is based on standard strain called Staphylococcus aureus ATCC25923, detect medicine sensitive situation by disk diffusion. Coagulase negative staphylococcus PCR reaction for detecting MecA, Erm(A/B/C), TetK, TetM gene and extract plasmid for researching method of transmission of drug-resistance gene.ResultThere is record for antibiotic use to the whole infectious patients, and only 40(13.3%)records of treatment with medicine sensitive situation. With normal WBC limits, the rate of antibiotic use is 79.4%. The drug-resistance level of cogulase negative staphylococcus is penicillin(100%), erythromycin(86.5%), gentamycin(84.3%), cephalosporin(>60%), laevoclination(58.4%), tetracycline(38.3%); 60 strains MRCNS from children are isolated, which contained 53 MecA gene rated 88.3%, ermA(38.3%), ermB(11.6), ermC(51.7%). From phenotype and genetic type it can be explained that the mechanism of resistant for tetracycline is encoded by TetK gene and there is another factors effected resistance mechanism of erythromycin .ConclusionThe antibiotic treatment methods is unsuitable .The proportion of MRCNS resistant is high about penicillin, erythromycin, cephalosporin, levofloxacin, tetracycline,it need to be given more attention. It can be explained that the mechanism of resistant for tetracycline is encoded by TetK gene and there is another factors effected resistance mechanism of erythromycin. MRCNS taken 4 types of plasmid, I type spread and the study also identify that the resistant gene can transmit with plasmid.