95株小儿呼吸道感染肺炎链球菌的耐药性研究

Antibiotic resistance of 95 strains of Streptococcus pneumoniae isolates from children′s sputum

目的:分析本院儿科患者下呼吸道感染肺炎链球菌的耐药情况,指导临床合理用药。方法:对本院2007年9月～2009年12月从儿科分离的95株肺炎链球菌用K-B纸片法检测其对青霉素等5种抗生素的敏感度,对耐苯唑西林的菌株用E-test法检测青霉素和头孢曲松的MIC值。结果:95株肺炎链球菌对红霉素、克林霉素高度耐药,耐药率分别为97.9%,96.8%,对左氧氟沙星几乎敏感,未检出耐万古霉素菌株。75株耐苯唑西林菌株用E-test法测试青霉素不敏感率为58.9%(56株),头孢曲松敏感率为98.7%(74株)。ermB基因介导的红霉素耐药菌株92株,占98.9%,mefE基因介导的红霉素耐药仅1株(1.1%)。结论:我院分离的肺炎链球菌耐药严重,PNSP检出率较高(58.9%),对红霉素、克林霉素高度耐药,临床应尽量减少此类药物的经验性用药,依据药敏结果选择抗菌药物进行治疗。

Objective：To analyse the antibiotic resistances of Streptococcus pneumoniae isolated from children and provide clinical guidelines for the rational use of antimicrobial agents.Methods：From September 2007 to December 2009,totally 95 clinical isolates of S.pneumoniae were used to determine the susceptibility of penicillin to 5 antimicrobial agents by K-B disk method,the MICs of oxacillin-resistant strains were performed byE-test.Results：The resistance rates of S.pneumoniae was relatively highly to erythromycin and clindamycin the resistance rates were 97.9%,96.8%.S.pneumoniae was vevry lower resistant to levofloxacin.No vancomycin-resistant strain was found.The isolation of PNSP was 58.9%,and the susceptibility of ceftriaxome was 98.7%.The ermB gene（98.9%） was predominant among isolates from children,while mefE was only 1.1%.Conclusion：The resistance of S.pneumoniae is serious in our hospital,and penicillin-nonsusceptible S.pneumoniae was increasing continuously,now was 58.9%.it is necessary to monitorits resistance of S.pneumoniae,and provide clinical guidelines for the rational use of antimicrobial agents.