苏州地区2010～2011年儿童临床分离肺炎链球菌耐药监测

Surveillance on antimicrobial resistance of Streptococcus pneumonia isolated from children in Suzhou Area

目的监测苏州地区儿童肺炎链球菌的临床分布及耐药性,为临床合理应用抗菌药物提供依据。方法对2010年1月～2011年6月门诊与住院患儿各临床标本分离的1 521株肺炎链球菌,采用梅里埃链球菌和肺炎球菌药敏试剂盒ATB STREP5进行MIC测定。结果 1 521株肺炎链球菌对青霉素不敏感率为43.6%,其中耐青霉素肺炎链球菌(PRSP)4.6%;低耐青霉素肺炎链球菌(PISP)39.1%。对阿莫西林、头孢噻肟、红霉素、克林霉素、四环素、复方新诺明、喹奴普丁/达福普丁,氯霉素,左旋氧氟沙星的耐药率为20.6%,21.0%,99.3%,97.6%,76.2%,92.0%,75.3%,7.0%,0.13%,未检出耐万古霉素肺炎链球菌。结论苏州地区儿童肺炎链球菌对青霉素耐药以低耐为主,青霉素仍是一个有效药物。对耐青霉素肺炎链球菌需做细菌药敏试验后再根据药敏结果合理选择用药。

Objective To investigate the clinical distribution and drug-resistance of S.treptococcus pneumonia isolated from children so as to provide guidance for rational clinical treatment.Methods 1 521 strains of S.pneumonia were collected between Jan.2010 and Jun.2011 and inhibition concentrations（MIC）were determinated with ATB STREPS from bioMérieux Industry.Results Resistant rate of S.pneumonia isolates to penicillin were 43.7% and among these strains 4.6% were resistance to PRSP,39.1% were lowly-resistant to PISP.The drug resistance rate to 10 antibiotics commonly used were as followed：20.6% for amoxicillin,21.0% for cefotaxime,99.3% for erythrocin,97.6% for Clindamycin,76.2% for tetracycline,92.0% for SMZ-TMP,75.3% for Quinupristin /dalfopristin,7.0% for chloromycetin,0.13% for Levofloxacin.No vacomycin-resistant strain was found.Conclusion Resistant rate of S.pneumonia to penicillin is mostly low.Thus it＇s effective for children to treat the disease caused by S.pneumonia.Moreover,rational use of penicillin is based on drug susceptibility test.