上海地区儿童肺炎链球菌耐药性研究

Study on drug resistance of S.pneumoniae in Shanghai′s children

目的 了解上海地区 2 0 0 1年小儿社区获得性呼吸道感染患儿肺炎链球菌 (SP)耐药情况 ,以指导临床抗生素合理使用。方法 用Kirby Bauer法和E test法检测 10 0株SP对青霉素等 10种抗菌药物敏感性。结果 SP总分离率 2 9 1% ;SP对青霉素耐药率 5 5 % ,最低抑菌浓度 (MIC90 ) 0 75mg/L ,MIC均值0 0 6mg/L ;对阿莫西林、阿莫西林 /克拉维酸和头孢曲松呈低耐药率 ,分别为 3 %、3 %和 6% ;对头孢克洛耐率15 % ;对头孢呋辛 2 9%。SP对氯霉素耐药 3 4% ,而对磺胺甲 口 恶唑 /甲氧苄啶、红霉素和四环素均呈高度耐药 ,达 80 %～ 82 %。结论 小儿SP耐药率远远高于成人 ,但阿莫西林和头孢曲松依然敏感 ,抗生素合理使用是重要的。

Objective To investigate the situation of S.pneumoniae (SP) resistance in Shanghai′s children with the community acquired respiratory tract infections (CARTIs) in 2001. Methods 100 strains of SP were isolated from nasopharyngeal secretions in CARTIs patients. The susceptibility of SP to 10 antibiotics were determined by K-B method and E-test method. Results The total isolated rate was 29.1% and the nonsusceptible isolates for penicillin was 55%. The MIC 90 was 0.75mg/L and the mean MIC was 0.06mg/L. The resistant rates of SP to amoxicillin, amoxicillin/clavulanic acid and ceftriaxone were low (3%～6%), but to cefaclor , cefuroxime and to chloramphenicol were 15%, 29% and 34% respectively. The prevalence of SMZ/TMP, erythromycin and tetracycline resistant rates were up to 80%～82%. Conclusions The antibiotic resistance of SP is much higher in children than in adults. Amoxicillin and ceftriaxone are still susceptible against SP. The rational use of antibiotics would be a very important problem.