某三甲医院两个院区间肺炎链球菌耐药性差异分析

DIFFERENCE IN DRUG RESISTANCE OF STREPTOCOCCUS PNEUMONIAEBETWEEN TWO BRANCHES OF A GRADE A TERTIARY HOSPITAL IN QINGDAO,CHINA

目的 比较青岛大学附属医院两个院区肺炎链球菌的耐药性差异,为指导临床用药提供理论依据。方法 回顾性分析青岛大学附属医院两个院区2015年1月—2018年10月分离的肺炎链球菌及其耐药性。结果本部院区分离肺炎链球菌233株,黄岛院区分离231株。两个院区肺炎链球菌对红霉素、四环素和复方磺胺甲噁唑的耐药率均超过50%,对青霉素的耐药率分别为25.79%和18.18%,对头孢噻肟、头孢曲松、氯霉素、莫西沙星和左氧氟沙星的耐药率低,未发现厄他培南、利奈唑胺和万古霉素耐药株。两个院区肺炎链球菌对阿莫西林、复方磺胺甲噁唑、红霉素、氯霉素、美罗培南、青霉素、四环素、头孢曲松、头孢噻肟、莫西沙星耐药率差异有显著性(χ^2=3.875~6.612,P<0.05)。结论 肺炎链球菌对大环内酯类、四环素类、复方磺胺类药物耐药率极高,这些药物不适用于临床治疗肺炎链球菌感染;两个院区肺炎链球菌的耐药性差异大,应根据药敏结果合理应用抗菌药物。

Objective To compare the drug resistance of Streptococcus pneumoniae between two branches of the Affiliated Hospital of Qingdao University, and to provide a theoretical basis for clinical medication. Methods A retrospective analysis was performed for the isolated Streptococcus pneumoniae and their drug resistance in two branches of the Affiliated Hospital of Qingdao University from January 2015 to October 2018. Results A total of 233 strains of Streptococcus pneumoniae were isolated in Shinan branch and 231 strains of Streptococcus pneumoniae were isolated in West Coast branch. The drug resistance rates of Streptococcus pneumoniae strains in the two branches to erythromycin, tetracycline, and compound sulfamethoxazole were >50%. The drug resistance rates of Streptococcus pneumoniae to penicillin in Shinan branch and West Coast branch were 25.79% and 18.18%, respectively. The Streptococcus pneumoniae had low drug resistance rates to cefotaxime, ceftriaxone, chloramphenicol, moxifloxacin, and levopropoxyphene. No strains resistant to ertapenem, linezolid, or vancomycin were detected. The drug resistance rates of Streptococcus pneumoniae to amoxicillin, compound sulfamethoxazole, erythromycin, chloramphenicol, merope- nem, penicillin, tetracycline, ceftriaxone, cefotaxime, and moxifloxacin were significantly different between the two branches (χ^2= 3.875 -6.612, P <0.05). Conclusion The drug resistance rates of Streptococcus pneumoniae to macrolides, tetracyclines, and compound sulfonamides are extremely high, and they are not recommended for pneumococcal infection in clinical practice. The drug resistance of Streptococcus pneumoniae differs significantly between the two branches, and rational antimicrobial agents should be selected according to the drug susceptibility results.