关键词: 革兰阳性球菌, 儿科, 耐药

Abstract: Objective To obtain a better insight of the drug-resistance rate of gram-positive cocci isolated from patients of 5 pediatric hospitals located in different areas of China.Methods From Jan 1st 2000 to Dec 31st 2006,a total of four type pathogenic strains were isolated from 5 pediatric hospitals which are Beijing Children's Hospital,Children's Hospital of Fudan University,Shanghai Children's Hospital,Guangzhou Children's Hospital and Chongqing Children's Hospital with both hospital acquired infection(HAI)and community acquired infection(CAI),and the number of the strains is 8215.The all 12063 strains were tested using Kirby-Bauer method.According to the criteria of guidelines of NCCLSof each year from 2000 to 2006,the R% were calculated to show the resistance and intermediate,and the S% for susceptible rate of bacteria to the compound tested.We chose Penicillin,Oxacillin,Amoxicillin and Clavulanat,Clindamycin,Cefuroxime,Ceftriaxone,Erythromycin,Compound Sulfamethoxazole and Vancomycin for testing S.aureus;Penicillin,Erythromycin,Clindamycin,Vancomycin,Ofloxacin and Compound Sulfamethoxazole for testing S.pneumoniae;Penicillin,Erythromycin,Clindamycin,Vancomycin and Ofloxacin for testing Group Astreptococci;Ampicillin,Streptomycin(highconcentration),Gentamycin(high concentration,Ciprofloxacin,Vancomycin,Teicoplanin,Erythromycin and Rifampicin for testing Enterococcus.Results Among a total of 4781 strains of S.aureus,the detectable rates of methicilin-resistant Staphylococcus aureus(MRSA)were6.87%,and the rate of resistance to erythromycin was 66.39% while the rate was rising.The rate of MRSA from two hospitals in Shanghai were higher than the others.All S.aureus isolates were susceptible to vancomycin;4781 strains of S.pneumoniae were isolated.The rate of penicillin unsusceptible Streptococcus pneumoniae(PRSP)was 68.64%,and the rate of resistance to erythromycin was 90.80% while the rate of both were going up;The total strains of 1301 Group Astreptococci were all susceptible to penicillin,with the rate of resistance to erythromycin was 80.94% which was rising by year,and we can see that rate of erythromycin-resistant were various from 100% to 52.08% by area;3.11% of all 1377 isolated Enterococcus strains were found intermediate to vancomycin,and the rate of ampicillin resistance was 48.03%.The rate of resistance to erythromycin was 86.47%.Conclusion Except Group Astreptococci,G+ coccus have a high resistance rate to penicillin;almost all G⁺ coccus were susceptible to vancomycin and teicomycin,but resistant to erythromycin with a trend of rising.MRSAwas low in rate,and we haven't find VRSA and VISA.But there was 3.11% of Enterococcus intermediate to vancomycin.So we should pay more attention to it.Antimicrobial resistant coccus of pediatric has already become a serious problem in China.Ongoing surveillance study on the antimicrobial resistance of gram-positive coccus is necessary for appropriate antimicrobial use in pediatric clinical work.

Key words: Gram-positive coccus, pediatric, drug resistance