青岛地区肺炎链球菌的耐药性检测

Surveillance of antimicrobial resistance of Streptococcus pneumoniae in Qingdao area

目的监测青岛地区肺炎链球菌的耐药性,为临床合理应用抗菌药物提供依据。方法采集青岛地区部分医院2003年1月—2004年12月门诊与住院1 973例临床呼吸道感染患者痰、咽拭子标本,培养、分离和鉴定肺炎链球菌。根据NCCLS的推荐,用稀释法、K-B法检测此菌对青霉素等10种抗菌药物的敏感度。结果1 973份标本中,检出肺炎链球菌107株(检出率为5.4%),其中44株(41.1%)对青霉素不敏感(22株为中介,22株为耐药株)。肺炎链球菌对头孢噻肟、阿莫西林和氯霉素的耐药率较低,分别为15.0%、15.0%和13.1%,对红霉素、四环素和复方磺胺甲噁唑有较高的耐药率,分别为73.8%、76.6%和91.6%,未检出对万古霉素耐药的菌株。结论青岛地区青霉素不敏感肺炎链球菌检出率高,除万古霉素外,对其他抗菌药物均有不同程度的耐药。

Objective To investigate the antimicrobial resistance of Streptococcus pneumoniae in Qingdao area for rational use of antibiotics. Methods From January 2003 to December 2004, effort was made to isolate S. pneurnoniae from sputum and throat swab samples in 1 973 inpatients and outpatients. Dilution method and K-B disk method were used to determine the susceptibility of S. pneumoniae to 10 antimicrobial agents. Results Of 1 973 clinical isolates, 107 （5.4%） were S. pneumoniae. Fortyfour of the 107 （41.1%） S. pneumoniae isolates were not susceptible to penicillin, including resistant （n=22） and intermediate （n = 22）. The resistance rate of S. pneumoniae was relatively lower to cefotaxime, amoxicillin and chloramphenicol （15.0%, 15.0% and 13.1 % respectively）. S. pneumoniae was highly resistant to erythromycin, tetracycline and TMP-SMZ. The resistance rates were 73.8%, 76. 6% and 91.6% respectively. No vancomycin-resistant strain was found. Conclusions Penicillin non-susceptible S. pneurnoniae is highly prevalent in Qingdao area. The isolates of S. pneumoniae also show various level of resistance to other antibiotics except vancomycin.