肺炎链球菌的侵袭性与非侵袭性感染及耐药性分析

目的分析肺炎链球菌(Spn)感染的临床特征及其耐药情况,为临床合理选用药物提供实验室参考依据。方法回顾性分析2012年1月到2016年12月非重复分离的186株Spn感染患者的临床资料和药敏数据,比较侵袭性和非侵袭性Spn感染的临床分布特征及耐药性差异。结果186例肺炎链球菌感染患者中,侵袭性感染34例,其中全血25例,胸腔积液5例,脑眷液2例,尿液2例;非侵袭性肺炎链球菌感染152例;均以内科和儿科为主;儿科侵袭性Spn感染构成比显著高于非侵袭性组(χ2=4.424,P=0.019)。感染患者男125例,女61例,年龄分布以老年人和婴幼儿为主,所有菌株对万古霉素、利奈哇険及泰利霉素100%敏感,对唆诺酮类、头孢曲松和尼他培南敏感性较高,对复方新诺明、四环素、红霉素耐药率比较严重。结论本地区5年间侵袭性和非侵袭性Spn感染病区分布不同,对冬种抗生素耐药性差异无统计学意义,实验室应定期对其进行耐药监测,以期对临床用药有所指导。

Objective To investigate the distribution and drug resistance of Streptococcus pneumoniae isolated from the invasive and non-invasive infections for reasonable application of antibiotics. Method The information of 186 strains isolated from patients with invasive and non-invasive infections were retrospective analyzed in our hospital from 2012 to 2016. Results A total 186 strains were isolated, of which 34 strains from invasive infection and 152 strains from non-invasive infection, the mainly department were internal medicine and paediatrics. The constituent ratio of invasive Spn infection in pediatrics was significantly higher than that in noninvasive group (χ2=4.424, P=0.019). All strains were 100% sensitive to vancomycin/Bnezolid/telithromycin.The resistance to erythromycin and tetracycline and SMZ-TMP was serious, the majority strains were sensitive to quinolones and ceftriaxone and Ertapenem. Conclusion The distribution of invasive and non-invasive Spn infections is different in this region during the past five years. There is no significant difierence in the resistance of various antibiotics. The laboratory should monitor the drug resistance regularly in order to provide guidance for clinical medication.