某地区肺炎链球菌感染分布及耐药性分析

Analysis in drug resistance and distribution of Streptococcus pneumonia infection in one area

目的了解四川地区肺炎链球菌(SP)的耐药情况,为临床合理用药提供依据。方法收集该院2013年1月至2016年6月临床分离的SP,对年龄、科室分布、标本类型、检出季节及药敏结果进行分析。结果 SP主要在春冬2个季节流行;婴幼儿感染为主,其次是老年人;儿科检出标本最多,检出率高于59%;痰标本检出菌株量最多,血液其次;SP对青霉素G耐药率呈逐年上升的趋势,对红霉素、四环素、复方磺胺甲噁唑的耐药率较高,但对万古霉素和利奈唑胺未出现耐药菌株,对左氧氟沙星和莫西沙星敏感率均高于95%,氯霉素敏感率也在87%以上。结论该地区SP对青霉素G的耐药率呈逐年上升趋势,对红霉素、四环素、复方磺胺甲噁唑耐药率较高,应加强合理用药管理,但左氧氟沙星、莫西沙星、万古霉素、利奈唑胺敏感率仍然较高,临床可合理使用。

Objective To investigate the dynamic changes of infection distribution,current resistance situation of Streptococcus pneumoniae（SP）in Sichuan area for the guidance of clinical therapy of SP.Methods The clinical result of SP from January 2013 to June 2016 were collected in our hospital.The age,distribution department,sample type,the season and drug susceptibility results were analyzed.Results Infections caused by SP was prevalent in spring and winter,and which mainly occurred in the infant and the elderly.The number of SP was maximum in the pediatrics,and the detection rate was above 59%.Clinical isolates of SP mainly were detected from sputum,followed by the blood.Penicillin G-resistant SP strains were isolated more and more from 2013 to 2016in Sichuan area.Erythromycin（E）,Tetracycline（TC）and Trimethoprim/Sulfamethoxazole（SXT）had the higher resistance.No drug-resistant strains of Vancomycin（VA）and Linezolid（LZD）were detected.Levofloxacin（LEV）and Moxifloxacin（MXF）were more sensitive,being more 95%,and the sensitive rate of Chlormycetin（CL）also was over 87%.Conclusion There is an upward trend to detect the penicillin G-resistant SP strains.Using of E,TC and SXT should be managed,because of its higher resisitance rate.However,LEV,MXF,VA and LZD could still be used by clinical doctors for its higher sensitive rate.