2009-2011年肺炎链球菌感染患者回顾性调查

Retrospective study of Streptococcus pneumoniae infection in 2009-2011

目的了解河北联合大学附属医院肺炎链球菌的标本、科室、季节感染的分布及耐药性,为临床医师正确、合理应用抗菌药物提供依据。方法回顾性分析2009年1月-2011年12月医院肺炎链球菌的临床资料,并对检出的肺炎链球菌进行感染资料及耐药性统计。结果在临床各类标本中共分离出196株肺炎链球菌,痰液、咽拭子为肺炎链球菌的主要标本来源,分别占81.12%、13.78%;肺炎链球菌在3年中不同阶段的检出率分别为1-4月份为36.74%、5-8月份为26.02%、9-12月份为37.24%,5-8月份与1-4月份和9-12月份相比差异有统计学意义(P<0.05),肺炎链球菌对阿米卡星、红霉素、克林霉素的耐药率均>80.0%。结论肺炎链球菌痰中检出最多,5-8月份检出量最少,在科室分布中差异较大,对红霉素等大环内酯类药物耐药性较高,临床应针对肺炎链球菌的标本、科室、季节感染的分布特点及耐药情况,制定合理有效的治疗及用药方案。

OBJECTIVE To understand the distribution of Streptococcus pneumoniae isolated from the specimens, departments, and seasons in the Affiliated Hospital of Hebei Union University and analyze the drug resistance so as to guide the reasonable clinical use of antibiotics, METHODS The clinical data of S. pneumoniae isolated from Jan 2009 to Dec 2011 were retrospectively analyzed, then the status of S. pneumoniae infections and the drug resistance were statistically analyzed. RESULTS A total of 196 strains of S. pneumoniae were isolated from a variety of clinical specimens, the sputum and throat swabs were the main specimen sources, accounting for 81.12% and 13.78%, respectively, during the three yeas of period, the detection rate in Jan-Apt was 36.74%, 26.02% in May-Aug, and a7.24% in Sep-Dec, the difference between the three time period was significant （P〈 0.05）, the drug resistance rates of the S. pneumoniae to amikacin, erythromycin, and clindamycin were more than 80.0 %. CONCLUSION The detection rate of S. pneumoniae is the highest in sputum and is the lowest during May-Aug, the S. pneumoniae varies greatly in the distribution of department and is highly resistant to such macrolides as erythromycin. It is necessary for the hospital to develop reasonable and effective treatment and medication programs according to the characteristics of distribution of S. pneumoniae in the specimens, departments, and seasons as well as the drug resistance.