2011—2016年某院肺炎链球菌的分布及耐药性

Distribution and Resistance to Antibiotics of Streptococcus Pneumonia Strains from A Hospital During 2011 to 2016

目的了解肺炎链球菌的临床分布及其对常用抗菌药物的耐药性,为临床合理选用抗菌药物提供参考依据。方法回顾分析华中科技大学同济医学院附属同济医院2011—2016年临床分离的肺炎链球菌的分布情况,纸片扩散法进行药物敏感性试验(青霉素和头孢曲松采用E试验法)。结果 2011—2016年该院共分离肺炎链球菌1 046株,其中来自成人患者300株,儿童患者746株。分离的肺炎链球菌主要来自痰标本,在成人组和儿童组所占的比例分别为62.3%和90.5%。科室分布主要为儿科,占59.6%。药敏结果显示成人组和儿童组的分离株对红霉素和克林霉素耐药率均超过85.0%。对青霉素(非脑膜炎折点)、莫西沙星、左氧氟沙星和万古霉素的敏感率均超过80.0%。结论该院分离的肺炎链球菌主要来自呼吸道标本,对红霉素和克林霉素的耐药率较高,红霉素和克林霉素已不适于肺炎链球菌感染的经验治疗,临床医师应根据药敏结果合理选用抗菌药物。

Objective To investigate the clinical distribution of Streptococcus pneumoniae and its drug resistance to commonly used antibiotics and provide reference for clinical reasonable selection of antibiotics.Methods Retrospective analysis of the distribution of Streptococcus pneumoniae isolated in Tongji hospital affiliated to Tongji medical college Huazhong university of science and technology during 2011 to 2016 was carried out.Drug susceptibility test was conducted by K-B method except for penicillin and cefatriaxone by E-test method.Results A total of 1 046 strains of Streptococcus pneumonia were isolated from specimens in hospital during 2011 to 2016,among them 300 strains were from adults patients and the other 746 strains were from children patients.Sputum was the most common specimen type and its ratio was 62.3%in adults group,90.5%in children group.Totally,59.6%of the strains were from department of pediatrics.The antibiotics sensitivity results showed that the resistance rate of the isolates to erythromycin and clindamycin was higher in adults and children,more than 85.0%.The susceptible rates of penicillin(non-meningitis break point),moxifloxacin,levofloxacin and vancomycin were higher than 80.0%.Conclusion In the hospital the isolates of Streptococcus pneumonia is mainly from respiratory specimens and the resistance rate to erythromycin and clindamycin was higher.Erythromycin and clindamycin are not suitable for the treatment of Streptococcus pneumoniae infection.Clinicians should select antibiotics according to the results of drug sensitivity.