肺炎链球菌对抗生素耐药性的研究

Antimicrobial resistance of Streptococcus pneumoniae: a comparison between the middle of 1980s and 1990s

目的研究８０年代中期和９０年代中期肺炎链球菌（Ｓｐ）对抗生素耐药性的变化。方法采用琼脂稀释法检测８０年代中期４９株和９０年代中期３３株Ｓｐ对１２种抗生素的敏感水平。结果Ｓｐ对青霉素的耐药率由８０年代中期的６％升至９０年代中期的２１％，对头孢呋新、头孢噻肟和亚胺培南的耐药率由０分别升至１５％、９％和１２％。对红霉素的耐药率变化最明显，由２％升至７９％。耐青霉素Ｓｐ可对头孢呋新、头孢噻肟、亚胺培南交叉耐药。９０年代中期Ｓｐ较８０年代中期耐药种类增多，在耐药模式上表现为８０年代中期Ｓｐ以耐四环素和耐四环素／氯霉素为主，９０年代中期的主要耐药模式除上述两种抗生素外还耐大环内酯类抗生素。结论本组实验对象所及范围内，９０年代中期Ｓｐ对青霉素、头孢呋新、头孢噻肟、亚胺培南和红霉素等抗生素的耐药性较８０年代中期明显增加，提示临床应合理使用抗生素。

Objective To study the antimicrobial resistance of Streptococcus pneumoniae (Sp) in 19831985 and 19951997 Methods The authors compared the susceptibility of Sp to antibiotics in 19831985 (49 isolates recovered from normally sterile body sites ) and 19951997 (33 isolates recovered from nasopharyngeal swabs, CSF and ear drainage of inpatients) with agar dilution Results Penicillinresistant Sp increased significantly from 6% in 19831985 to 21% in 19951997 The resistance of Sp to cefuroxime, cefotaxime, imipenem increased from 0 to 15%, 9% and 12%, respectively Erythromycinresistant Sp increased significantly from 2% to 79% The categories of resistance increased in 19951997 compared to the period 19831985 Some penicillinresistant Sp were resistant to cefuroxime, cefotaxime and imipenem simultaneously The main patterns in 19831985 were tetracycline and tetracycline/chloramphenicol; in 19951997 erythromycin, clarithromycin, clindamycin were added to the main patterns Conclusion The antimicrobial resistance of Sp to penicillin, cefuroxime, cefotaxime, imipenem, erythromycin etc had increased in 1995 1997 as compared to 19831985 within the scope of this study Rational use of antibiotics should be emphasized