儿童社区获得性呼吸道感染的肺炎链球菌和流感嗜血杆菌耐药性监测  

Surveillance of antimicrobial resistance in isolates of Streptococcus pneumoniae and Haemophilus influenzae from children with community-acquired respiratory tract infection

作　　者：俞桑洁[1] 沈叙庄[1] 袁林[1] 佟月娟[1] 高薇[1] 王咏红[1] 李艳[1] 杨永弘[1] 

机构地区：[1]首都医科大学附属北京儿童医院儿科研究所微生物室,100045

出　　处：《中国抗感染化疗杂志》2005年第5期297-300,共4页Chinese Journal of Infection and Chemotherapy

基　　金：十五攻关项目(编号:2003BA712A11-20);国家自然科学基金资助项目部分工作(编号:30070793)

摘　　要：目的监测2000—2004年连续5年5岁以下呼吸道感染患儿鼻咽拭子分离的肺炎链球菌和流感嗜血杆菌对抗菌药物的耐药性。方法采用E试验和K-B纸片法对临床分离541株肺炎链球菌、521株流感嗜血杆菌进行抗菌药物耐药性测定。结果肺炎链球菌对青霉素不敏感率由2000年的22%增加到2004年的32.9%,P<0.05;对头孢呋辛和头孢克洛不敏感率由7%增加到25%左右,P<0.01;对红霉素不敏感率由88%增加到94.3%,P>0.05;对四环素和复方磺胺甲噁唑不敏感率分别为90%以上和80%以上。流感嗜血杆菌对氨苄西林耐药率和产β内酰胺酶率由2000年的5.0%增加到2004年的14.3%,P<0.05;对阿莫西林-克拉维酸、头孢曲松和头孢呋辛非常敏感;对头孢克洛不敏感率由2%增加到14.3%,P<0.01。结论肺炎链球菌对青霉素不敏感率和流感嗜血杆菌对氨苄西林耐药率和产β内酰胺酶率呈明显上升趋势。Objective This surveillance was conducted in Beijing Children＇s Hospital from 2000 to 2004 to determine the in vitro activity of selected antimicrohial agents against common respiratory pathogens, including Streptococcus pneumoniae and Haemophilus influenzae, isolated from children less than 5 years of age with respiratory tract infection. Methods Susceptibility testing was performed for 541 strains of S. pneumoniae and 521 strains of H. influenzae using the NCCLS （M100-S12） E test and K-B disk method. Results The prevalence of penicillin-non-susceptible pneumococci increased from 22% in 2000 to 32.9% in 2004 （P〈0.05）. The resistance rate of S, pneumoniae to cefaclor and cefuroxime increased from 7% to 25% （P〈 0.01）. The resistance rate of S. pneumoniae to erythromycin increased from 880/00 to 94.3% （P）0.05）. The proportion of ampicillin-resistant and β-lactamase-producing H, influenzae rose gradually from 5.0% in 2000 to 14.3 % in 2004 （P〈0.05）. All H. influenzae strains were extremely susceptible to amoxicillin-clavulanic acid, cefuroxime, ceftriaxone. The proportion of cefaclor non-susceptible H. influenzae strains increased from 2 % to 14.3 % （P〈0.01）. Conclusions Penicillin non-susceptible S. pneumoniae isolates and ampicillin-resistant and beta-lactamase-producing H. influenzae strains increased significantly.

关 键 词：肺炎链球菌 流感嗜血杆菌 抗生素耐药 

分 类 号：R725.6[医药卫生—儿科]