肺炎链球菌100株耐药性分析

Antibiotics-resistance study of 100 strains of Streptococcus pneumoniae

目的 了解杭州地区小儿肺炎链球菌致病株的耐药特征。方法 用Kirby -Bauer法对浙江大学儿童医院 2 0 0 1年 7月至 2 0 0 2年 1月鉴定的 10 0株肺炎链球菌进行耐药性分析 ,同时用E -test法测定青霉素、氨苄西林、头孢噻肟和红霉素的最低抑菌浓度。结果 青霉素不敏感株 6 1株占 6 1% ,其中中介株占 46 % ,耐药株占15 % ,其最低抑菌浓度范围为 0 0 16～ 3 0 0 0mg/L ,平均 0 5 2 3mg/L。 92 %的菌株对红霉素耐药 ,对四环素、复方新诺明的耐药率也分别高达 85 %和 5 6 % ,氯霉素的耐药率为 16 %。多重耐药率为 6 3 % ,其中多数对红霉素、四环素和复方新诺明联合耐药。 99%的菌株对利福平敏感。未发现氨苄西林耐药株 ,但中介株达 43 %。所有的菌株都对头孢噻肟、万古霉素和氧氟沙星敏感。结论 杭州地区肺炎链球菌耐药现象比较严重 ,第三代头孢菌素是临床治疗耐青霉素肺炎链球菌感染的理想药物。

Objective To investigate the antibiotics-resistance type of Streptococcus pneumoniae isolated from children in Hangzhou.Methods The sensitivities of 12 antibiotics to 100 strains of Streptococcus pneumoniae were determined in intro by Kirby-Bauer-diffuse methods and MICs of penicillin,ampicillin,cefotaxime and erythromycine were determined by E-test methods.Results Among all 100 strains isolated from children during the period from July 2001 to January 2002,61 strains(61%) were nonsensitive to penicillin,including 46 intermediary strains and 15 resistant strains.Penicillin MICs arranged from 0 016 mg/L to 3 0 mg/L and averaged 0 523 mg/L.The most inactive antibiotics was erythromycine and its resistant rate was as high as 92%,followed by tetracycline(85%),SXT(56%) and chloromycetin(16%).43 strains (43%) were intermediary but none was resistant to ampicillin. 63 strains(63%) were multi-resistant pneumococci and most of them were resistant to SXT,erythromycine and tetracycline at the same time.All of the pneumococci were sensitive to vacomycine,cefotaxime and ofloxacin.Conclusionons The antibiotics-resistance rate to pneumococci is high in Hangzhou, but the third-generation cephalosporins are still the best antibiotics against Streptococcus pneumoniae.