133株肺炎链球菌耐药性分析

Antimicrobial resistance of 133 strains of Streptococcus pneumoniae

目的了解本院肺炎链球菌分布和耐药情况。方法对本院2005年1月—2007年7月从临床分离的133株肺炎链球菌采用K-B纸片扩散法检测其对青霉素等7种抗生素的敏感度,用E-test法检测对苯唑西林耐药的肺炎链球菌青霉素的MIC值。结果青霉素的耐药呈上升趋势,尤其是2007年上半年。肺炎链球菌对四环素(TCY)、红霉素(ERY)、克林霉素(CLI),有较高的耐药率,分别为63.2%、59.4%、51.9%,对青霉素(PEN)、氯霉素(CHL)、左旋氧氟沙星(LEV)的耐药率较低,分别为15.0%、12.8%、3.0%,未检出对万古霉素耐药的菌株。青霉素不敏感肺炎链球菌(PNSSP)的E-test检测结果以中介菌株为主,PNSSP的MIC值最高达到6μg/ml。结论本院分离的肺炎链球菌耐药较为严重,耐青霉素的肺炎链球菌不断上升,有必要对其进行耐药性监测,指导临床合理选择抗菌药物。

Objective To investigate the distribution and antimicmbial resistance of Streptococcus pneumoniae in our hospital. Methods From January 2005 to July 2007, totally 133 clinical isolates of S. pneumoniae were used to determine the susceptibility of penicillin to 7 antimicrobial agents by K-B disk method, the MICs of oxacillin-resistant strains were performed by E-test. Results The resistance of penicillin showed ascending tendency, especially in the first half of 2007. The resistance rates of S. pneumoniae was relatively highly to tetracycline （TCY）, erythromycin （ERY）, clindamycin （CLI）, the resistance rates were 63.2%, 59.4% 、 51.9% respectively. S. pneumoniae was lower resistant to penicillin （ PEN ）, chloromycetin （CHL）, levofloxacin （LEV） , the resistance rates were 15.0%, 12. 8%, 3.0% respectively. No vancomycin-resistant strain was found. The result of PNSSP strains were the intermediate type, and the highest MICs of PNSSP was 6μg/ml. Conclusion The resistance of S. pneumoniae is serious in our hospital, and penicillin-resistant S. pneumoniae was increasing continuously, it is necessary to monitor its resistance of S. pneumoniae, and provide clinical guidelines for the rational use of antimierobial agents.