山东省泰安市2015—2020年肺炎链球菌分离株的耐药性变迁

Drug resistance changes of Streptococcus pneumoniae in Taian,Shandong,2015-2020

目的了解泰安市肺炎链球菌(Streptococcus Pneumonia,SP)分布及耐药性变迁,为临床合理使用抗菌药物提供实验室依据。方法收集山东省泰安市中心医院2015—2020年临床分离的肺炎链球菌资料,使用奥普托欣敏感试验和郑州安图全自动微生物质谱检测系统Autof ms1000进行细菌鉴定。采用纸片扩散法进行药物敏感性试验,其中青霉素、美罗培南、头孢噻肟、头孢曲松和头孢吡肟则采用E-test试验法,应用WHONET 5.6软件对药敏结果进行统计分析。结果2015—2020年,在各类临床标本中共分离出SP菌株2095例,各年度分别检出256株、429株、388株、381株、484株和157株。主要标本来源为痰液,其次为血液与脑脊液,分别占88.74%、2.24%和1.00%。以冬季分离菌株最多(占39.24%);年龄以0~<15岁的儿童为主(占63.10%)。科室以儿内科病房为主(占60.76%)。药敏结果显示,SP对临床常用抗菌药物敏感性较好,未发现对万古霉素、利奈唑胺耐药菌株,利福平、头孢吡肟、头孢噻肟、头孢曲松、美罗培南、莫西沙星以及青霉素耐药率均低于1%。但对红霉素、克林霉素均处于高耐药水平,各年度耐药率均在96%以上。结论泰安市肺炎链球菌主要来源于儿内科病房0~<15岁的儿童,以呼吸道标本为主,以冬季检出最多。对常用抗菌药物的敏感情况良好,但红霉素和克林霉素耐药情况严峻。临床医生应根据药敏试验结果选择合理的抗生素。

Objective hospital in Taian,and we provide laboratory basis for rational use of antibiotics in clinic.Methods Streptococcus pneumonia isolated from the Tai′an City Central Hospital in Shandong Province during 2015-2020 was analyzed retrospectively.The bacteria were identified by Optochin sensitivity test and Autof MS1000 automatic microbial mass spectrometry system.The sensitivity tests were carried out by the paper diffusion method,and penicillin,meropenem,cefotaxime,ceftriaxone and cefepime were tested by E-test,and the results were statistically analyzed by WHONET 5.6 software.Results specimens in our hospital,and the number of detected strains in each year was 256,429,388,381,484 and 157,respectively.The main samples were sputum,followed by blood and cerebrospinal fluid,accounting for 88.74%,2.24% and 1.00%,respectively.The bacterial strains were mainly isolated in winter,accounting for 39.24%.In terms of age distribution,the children aged 0-<15 years were the main group,with a proportion of 63.10%.At the same time,the Department of Pediatrics was main separate department(60.76%).Drug sensitivity results showed that SP was sensitive to commonly used antibiotics in clinical use,no strains resistant to vancomycin and linezolid were found,and drug resistance rates of rifampicin,cefepime,cefotaxime,ceftriaxone,meropenem,moxifloxacin and penicillin were all lower than 1%.However,it was highly resistant to erythromycin and clindamycin,and the annual resistance rate was above 96%.Conclusion mainly came from children aged 0-<15 years in the pediatrics ward of our hospital,mainly from respiratory specimens,most of which were detected in winter.The sensitivity to common antibacterial agents was good,but the resistance to erythromycin and clindamycin was severe.Clinicians should choose reasonable antibiotics according to the results of drug sensitivity test.