52株肺炎链球菌临床分离株耐药情况分析

Investigation on antibiotic susceptibility of 52 strains of Streptococcus pneumoniae

目的：调查临床分离肺炎链球菌对常用抗菌药物的耐药状态,为临床用药提供依据。方法：2007~2008年间52株临床分离肺炎链球菌经VITKE-AMS-60全自动细菌鉴定仪GPI卡鉴定后,采用琼脂稀释法测定最低抑菌浓度。结果：52株肺炎链球菌中,青霉素不敏感菌株32株,占61.5%,对头孢噻肟、头孢曲松有较好的敏感性,耐药率仅为21.2%和5.8%,而对头孢呋辛的耐药率则达50.0%。对红霉素、阿奇霉素、克林霉素高度耐药,均达92.3%,氯霉素的耐药率为15.4%,而对万古霉素和左氧氟沙星呈现高敏感性,敏感率分别达100%和98.1%。并且青霉素耐药菌株呈现多重耐药性比青霉素敏感株明显。结论：临床分离肺炎链球菌对万古霉素、左氧氟沙星敏感性高,对头孢噻肟、头孢曲松、头孢呋辛以及氯霉素比较敏感,对青霉素耐药率比较严重,而对红霉素、阿奇霉素和克林霉素普遍耐药。

Objective：To investigate the antimicrobial resistance of clinical Streptococcus pneumoniae.Methods：The minimum inhibitory concentration（MIC） of the 52 strains of S.pneumoniae isolated between 2007 and 2008 were determined by agar-dilution method,followed by identification with VITKE-AMS-60.Results：Of the 52 strains,61.5%（32 strains） were not susceptible to penicillin.Overall resistance of isolates was 21.2% to cefotaxime,5.8% to ceftriaxone,and 50.0% to Cefuroxime respectively.And almost all of the isolates（92.3%） were resistant to erythromycin,azithromycin and clindamycin.The resistant prevalence to chloramphemicol was 15.4%,while high susceptible to vancomycin（100%） and levofloxacin（98.1%） were also present.It was more vulnerable to present the multi-resistance in penicillin non-susceptible isolates than those susceptibleones.Conclusion：The clinical S.pneumoniae isolates are susceptible to vancomycin,levofloxacin but not susceptible or resistant to penicillin.The isolates have susceptibility to cefotaxime,ceftriaxone,cefuroxime and chloramphemicol to a certain extent.There is a prevalent resistance to erythromycin,azithromycin and clindamycin.