青岛地区部分医院2005-2008年肺炎链球菌的耐药性分析

Analysis resistance of Streptococcus pneumoniae of some hospital in Qingdao from 2005 to 2008

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2005年1月到2008年12月门诊与住院感染患者呼吸道、血液、脑脊液等标本，培养、分离和鉴定肺炎链球菌。根据NCCLS的推荐，采用琼脂微量稀释法测定分离出的231株肺炎链球菌对11种常用抗菌药物的耐药性，分析耐药趋势及年龄差异。结果231株肺炎链球菌对青霉素不敏感率为23．38％[耐青霉素肺炎链球菌（PRSP）：9．52％；低耐青霉素肺炎链球菌（PISP）：13．85％]。对头孢噻肟耐药率最低为9．96％（23／231），其次阿莫西林为12．55％（29／231）。对红霉素耐药率最高为90．48％（209／231）。14岁以下患者PRSP检出率为27．91％（12／43），明显高于成人的PRSP检出率5．38％（10／186）。结论本地区PRSP检出率较2004年前明显增加，并有逐年增加的趋势，肺炎链球菌的耐药性也有逐年上升的趋势。本地区对感染低耐青霉素肺炎链球菌的患者头孢噻肟、阿莫西林可为首选药物。

Objective To monitor the resistance of Streptococcus pneumoniae following the 2004 in Qingdao area, and to provide a reasonable basis for clinical application of antimicrobial agents. Methods Collecting respiratory tract, blood, cerebrospinal fluid and other specimens from out-patient and in-patients of some hospital in Qingdao from January 2005 to December 2008. According to the recommendation of NCCLS, antibiotic resistance analysis of 11 kinds of antibiotic to the isolated 231 Streptococcus pneumoniae by micro-agar dilution method, and analysis resistance trends and age differences. Results The results showed that the rate of Streptococcus pneumoniae not sensitive to penicillin is 23.38% （ PRSP： 9.52% , PISP： 13.85% ） , resistant to cefotaxime is 9.96% （23/231）, resistant to amoxicillin is 12. 55%, resistant to erythromycin is 90.48% （209/231）. PRSP rate of patients younger than 14 years of age 27.91% （12/43） , significantly higher than that of the PRSP rate of adults 5.38% （10/186）. Conclusion The rate of resistant to penicillin Streptococcus pneumoniae increased significantly from 2004, and an increasing trend year by year, the resistance of Streptococcus pneumoniae is also a rising trend year by year. For patients infected low penicillin-resistant Streptococcus pneumoniae in this region, cefotaxime, amoxicillin are preferred drugs.