豫北地区肺炎链球菌感染分布和耐药性分析

Distribution and drug resistance analysis of streptococcus pneumoniae infection in North Henan Province

目的了解肺炎链球菌（SP）的临床分布及其耐药情况,指导临床医师合理使用抗生素,以延缓多重耐药菌株的产生并有效预防医院获得性感染。方法收集2015年1～12月新乡医学院第一附属医院检验科分离出的641株SP,采用纸片扩散法进行鉴定及药物敏感试验。分析SP感染患者的年龄分布、标本来源、科室分布及药物敏感试验结果。结果 SP感染者年龄多分布在9岁以下,标本类型主要是痰液（587份,91.6%）。SP对14种抗生素的药物敏感试验结果显示,SP对氯霉素（0.8%）、万古霉素（0.8%）、左旋氧氟沙星（0.6%）及利奈唑胺（0.0%）的耐药率较低;而对克林霉素（99.8%）、复方磺胺甲唑（98.3%）、红霉素（99.8%）、四环素（99.5%）的耐药率较高。结论 SP感染者多为儿童,且对抗菌药物存在多重耐药性,临床医生应加强其耐药性检测,合理选择抗菌药物,以减少多重耐药菌株的出现。

Objective To explore the clinical distribution and drug resistance of streptococcus pneumoniae（SP） ,in or- der to direct doctors to put antibiotics into intelligent use, delay the occurrence of bacterial drug resistance, and effectively pre- vent the acquired infection. Methods A total of 641 SP were collected in Department of Laboratory Medicine of the First Af- filiated Hospital of Xinxiang Medical University from January to December 2015. The bacteria was separately cultivated and the bacterial identification and drug-sensitivity test were made through Kirby-bauer method. The age distribution, specimen source, division distribution and the result of drug sensitive detection were analyzed. Results The infected cases were mainly under nine years old. The samples were basically isolated from sputum（587,91.6% ）. The drug sensitivity test result of SP for 14 kinds of antibiotics showed that chloromycetin （ 0.8 % ） , vancomyeiu （ 0.8 % ） , levofloxacin （ 0.6 % ） and linezolid （ 0.0% ） had low drug resistance. However, clindamycin（99.8% ）, betrim （98.3 % ）, erythromycin （99.8%） and achromycin （99.5 % ） all had a high drug resistance to SP. Conclusion People inflected SP were mainly children and have multiple drug resistance a- gainst antibacterial drug, therefore doctors should strengthen the testing of drug resistance and choose antibacterial drug reason- ably so as to lower the occurrence of muhiple drug resistance strains.