中国临床药理学杂志

儿童侵袭性克林霉素耐药社区相关性MRSA感染的诊疗与结局

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程明 ^a , 张晓娟 ^b

中国临床药理学杂志 | 临床与基础桥接研究 2026,42(10): 1371-1377

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中国临床药理学杂志 |临床与基础桥接研究 2026 , 42 (10) : 1371 -1377

儿童侵袭性克林霉素耐药社区相关性MRSA感染的诊疗与结局

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程明^a, 张晓娟^b

作者信息

^a.江南大学附属儿童医院（无锡市儿童医院），新生儿外科，江苏无锡 214000

^b.江南大学附属儿童医院（无锡市儿童医院），感染性疾病科，江苏无锡 214000

通讯作者:

张晓娟，副主任医师 MP: 15061576332 E-mail: zxj05210@126.com

作者简介:

程明（1980-），男，主治医师，主要从事新生儿外科和儿童普外科疾病的工作

Diagnosis, treatment, and outcomes of invasive clindamycin-resistant community-associated MRSA infections in children

Ming CHENG^a, Xiao-juan ZHANG^b

Affiliations

^a.Neonatal Surgery Department, Affiliated Children’s Hospital of Jiangnan University (Wuxi Children’s Hospital), Wuxi 214023, Jiangsu Province, China

^b.Department of Infectious Diseases, Affiliated Children’s Hospital of Jiangnan University (Wuxi Children’s Hospital), Wuxi 214023, Jiangsu Province, China

出版时间: 2026-05-28 doi: 10.13699/j.cnki.1001-6821.2026.10.004

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摘要

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目的

本研究旨在重新评估某三级儿童医院对侵袭性社区相关性耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染的抗生素治疗方案。

方法

回顾性分析2020~2025年期间无基础疾病儿童的侵袭性克林霉素耐药社区相关性耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染病例，共34例患儿符合纳入标准，最常见的诊断类型为骨髓炎（17例）和深部脓肿（7例）。

结果

静脉抗生素治疗（Ⅳ therapy）中位时长为11.5 d（四分位距6~42 d），总治疗时长（静脉+口服）为32 d（四分位距23~42 d）。总体而言，50%的患儿后续转为口服抗生素治疗。用于治疗的确定性抗生素包括万古霉素（15例）、TMP-SMX（9例）、利奈唑胺（7例）、头孢洛林（2例）和多西环素（1例）。不同确定性抗生素治疗方案的治愈率相近：万古霉素组73.3%、TMP-SMX组88.9%、头孢洛林组50%、利奈唑胺组和多西环素组均为100%。3例患儿因MRSA感染死亡，其中2例采用万古霉素治疗，1例采用头孢洛林治疗。

结论

万古霉素是治疗儿童侵袭性克林霉素耐药CA-MRSA感染最常用的药物。但在特定病例中，完成治疗阶段可考虑将TMP-SMX和利奈唑胺作为口服备选方案。未来仍需进一步研究以优化这类感染的治疗方案。

关键词

耐甲氧西林金黄色葡萄球菌 / 侵袭性 / 克林霉素耐药 / 儿童

Abstract

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Objective

This study aimed to reassess the antibiotic treatment regimen for invasive community-associated methicillin-resistant Staphylococcus aureus(CA-MRSA) infections at a tertiary children’s hospital.

Methods

A retrospective analysis was conducted on cases of invasive clindamycin-resistant MRSA infections in children without underlying diseases between 2021 and 2025. A total of 34 children met the inclusion criteria, with the most common types of diagnosis being osteomyelitis (17 cases) and deep abscess (7 cases).

Results

The median duration of intravenous (IV) antibiotic therapy was 11.5 days (interquartile range [IQR], 6-42 days), and the total treatment duration (IV + oral) was 32 days (IQR, 23-42 days). Overall, 50% of the children were subsequently switched to oral antibiotic therapy. The definitive antibiotics used for treatment included vancomycin (15 cases), TMP-SMX (trimethoprim-sulfamethoxazole, 9 cases), linezolid (7 cases), ceftaroline (2 cases), and doxycycline (1 case). The cure rates of different definitive antibiotic treatment regimens were similar: 73.3% in the vancomycin group, 88.9% in the TMP-SMX group, 50% in the ceftaroline group, and 100% in both the linezolid group and the doxycycline group. Three children died from MRSA infection, among whom 2 were treated with vancomycin and 1 with ceftaroline.

Conclusion

Vancomycin is the most commonly used drug for the treatment of invasive clindamycin-resistant CA-MRSA infections in children. However, in specific cases, TMP-SMX and linezolid may be considered as oral alternative options during the completion phase of treatment. Further research is still needed in the future to optimize the treatment regimen for such infections.

Key words

MRSA / invasive / clindamycin-resistant / children

引用本文

程明, 张晓娟. 儿童侵袭性克林霉素耐药社区相关性MRSA感染的诊疗与结局. 中国临床药理学杂志, 2026 , 42 (10) : 1371 -1377 . DOI: 10.13699/j.cnki.1001-6821.2026.10.004

Ming CHENG, Xiao-juan ZHANG. Diagnosis, treatment, and outcomes of invasive clindamycin-resistant community-associated MRSA infections in children[J]. Chinese Journal of Clinical Pharmacology, 2026 , 42 (10) : 1371 -1377 . DOI: 10.13699/j.cnki.1001-6821.2026.10.004

基金

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无锡市卫生健康委科研项目(M202407)

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2026年第42卷第10期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2026.10.004

接收时间：2025-10-30
首发时间：2026-08-06
出版时间：2026-05-28

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收稿日期：2025-10-30

基金

无锡市卫生健康委科研项目(M202407)

作者信息

^a.江南大学附属儿童医院（无锡市儿童医院），新生儿外科，江苏无锡 214000

^b.江南大学附属儿童医院（无锡市儿童医院），感染性疾病科，江苏无锡 214000

通讯作者:

张晓娟，副主任医师 MP: 15061576332 E-mail: zxj05210@126.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2026.10.004

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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