Clinical Features Of Staphylococcus Aureus Pneumonia In Children And Its Antimicrobial Resistance

Objective： To investigate the clinical features of staphylococcusaureus pneumonia (SAP) and its antimicrobial resistance in children，so asto provide the evidence for clinical diagnosis and treatments of SAP.Methods：44SAP children were enrolled retrospectively in Children’sHospital, Chongqing Medical University from September2008toDecember2013. The clinical features of SAP and antimicrobial resistancewere analyzed．Results：(1)We identified44cases of SAP．The ratio of SAP boys andgirls was2.67:1．The peak age is younger than3years old and older than6years. SAP had severer manifestations than other common bacterialpneumonia. The typical symptoms included prolonged or recurrent fever,and septic shock.30（68.2%） patients had leukocytosis，36（81.8%）patients had increased neutral proportion.42ptients had C-reactiveprotein (CRP) and33(78.6%) of them had increased CRP.21patients hadprocalcitonin (PCT) and all of them had increased PCT.39（88.6%）patients had complications. SAP prone to cause multi-organ infection and multiple organ dysfunction.(2) The antibiotic resistant rates of these SAto ampicillin(100%vs96.2%), amoxicillin/clavulanate（42.5%vs3.8%）,ciprofloxacin（9.3%vs0%）and rifampin（7.3%vs0%）were higher thanSA from1993to2003in our hospital. Of these SA，15strains(34.1％)isolates were Methicillin-resistant Staphy1ococcus aureus（MRSA） and29strains(85.5％) were Methicillin-sensitive Staphy1ococcus aureus（MSSA）． The resistant rates of SA to Penicillin, ampicillin,erythromycin, clindamycin, cefoxitin, amoxicillin/clavulanate were100%,100%,74.4%,73.8%,58.6%,42.5%,39.0%, respectively．Theresistant rates of SA to tetracycline, oxacillin, trimethoprim pyrimidinenitrogen, cotrimoxazole, tobramycin Gentamicin, mupirocin, amikacin,ciprofloxacin, rifampin, mupirocin-HL, nitrofurantoin were29.3%,28.6%,26.2%,23.8%,19.0%,18.2%,9.5%,9.3%,7.3%,4.7%,2.4%,respectively．All the SA strains were sensitive to vancomycin, teicoplaninLalin, linezolid, dalfopristin, fusidic acid resistant strains． Difference inresistant rate of Oxacillin, cefoxitin, erythromycin, clindamycin, rifampin,amoxicillin/clavulanic acid between MRSA and MSSA is statisticallysignificant (P<0.05), and MRSA group is much higher drug-resistantrate.Conclusions： Staphylococcus aureus pneumonia has the higherincidence in children younger than3years old and older than6years oldin Chongqing. The multiple antibiotic resistance rates of Staphylococcus aureus increased in Chongqing. SAP had severer manifestations than othercommon bacterial pneumonia, prone to cause the multiple organcomplications.Staphylococcus aureus have high resistant to beta-lactamantibiotics, MRSA show higher antibiotic resistance than MSSA.