广东东莞地区儿童肺炎链球菌和流感嗜血菌携带和耐药性研究

Study on antibiotic resistance of Streptococcus pneumoniae and Hemophilius influenzae isolated from child carriers Dongguan city

目的总结和分析东莞地区学龄前健康儿童鼻咽部携带肺炎链球菌和流感嗜血菌情况和对常用抗生素耐药特点，为预防儿童肺炎链球菌和流感嗜血菌感染和合理利用抗生素提供参考。方法采用专用巧克力和血平板培养基对采集的400名3～5岁儿童鼻咽分泌物培养并鉴定，对鉴定明确的肺炎链球菌和流感嗜血菌进行不同抗生素检测。结果该地区儿童肺炎链球菌和流感嗜血菌携带率分别是34．5％和26．8％；药敏检测显示，肺炎链球菌对万古霉素、左氧氟沙星、氯霉素、复方磺胺甲晤唑、苯唑西林、四环素、红霉索耐药率分别为0、2％、24％、42％、64％、74％和78％；流感嗜血菌对头孢噻肟、环丙沙星、左氧氟沙星耐药率均为2％，氨苄西林和四环素耐药率均为8％，亚胺培南为10％。复方磺胺甲略唑耐药率为12％。氯霉索和氨曲南耐药率均为28％。利福平为90％，对头孢呋辛和头孢克洛敏感。结论本地区健康学龄前儿童鼻咽部肺炎链球菌和流感嗜血菌携带率高于国内许多地区，对常用抗生索耐药性严重。并存在多重耐药现象。

Objective To analyze of Streptococcus pneumoniae （Sp） and Hernophilus influenzae （Hi） isolated from child carriers in Dongguan and the antibiotic resistance profile. Methods Four hundred samples of rhinopharynx secretion from children 3-5 years old were cultured with special chocolate and blood medium plate. Sp and Hi isolated were tested for antibiotic susceptibility. Results The detection rate of Sp and Hi was 34.5% and 26.8% respectively. The resistance rate of Sp to vancomycin, levofloxacin, chloramphenicol, trimethoprim-sulfamethoxazole, oxacillin, tetracycline and erythromycin was 0, 2%, 24%, 42%, 64%, 74% and 78% respectively. And the resistance rates of Hi to cefotaxime, ciprofloxacin and levofloxacin were all 2%, ampicillin and tetracycline 8%, imipenem 10%, trimethoprim-sulfamethoxazole 12%, chloramphenicol and atreonam 28%, rifampicin 90%, and it was sensitive to cefuroxime and cefaclor. Conclusion The detection rate of Sp and Hi to children in Dongguan was higher than other regions. Of particular note the situation of resistance to antibiotic and multi resistant were serous.