不同血清型肺炎链球菌对非β内酰胺类抗生素的耐药性  

Susceptibility of Streptococcus pneumoniae to non β-lactam antibiotics by serotype

作　　者：姚开虎[1] 陆权[2] 邓力[3] 俞桑洁[1] 张泓[4] 邓秋莲[5] 沈叙庄[1] 杨永弘[1] 

机构地区：[1]首都医科大学附属北京儿童医院微生物免疫室,100045 [2]上海交通大学附属儿童医院呼吸科 [3]广州市儿童医院呼吸科 [4]上海交通大学附属儿童医院检验科 [5]广州市儿童医院检验科

出　　处：《中国感染与化疗杂志》2007年第6期404-407,共4页Chinese Journal of Infection and Chemotherapy

基　　金：国家自然科学基金资助项目(30070793)

摘　　要：目的了解不同血清型的肺炎链球菌对非β内酰胺类抗菌药物的耐药特点。方法以2000—2002年于北京、上海和广州3所儿童医院门诊分离的625株肺炎链球菌为研究对象,应用简易棋盘式肺炎链球菌分型系统分析血清型;采用E试验(青霉素和红霉素)和K-B纸片扩散法(复方磺胺甲噁唑、四环素和氯霉素)检测菌株对抗菌药的敏感性。结果常见的血清型/群为19群、23群、6群和14型。常见血清型菌株对红霉素、四环素、复方磺胺甲噁唑不敏感率均明显高于其他少见血清型和不能分型组。青霉素不敏感菌(PNSP)对红霉素和复方磺胺甲噁唑的不敏感率明显高于青霉素敏感菌(PSSP);不能分型的PNSP对红霉素和复方磺胺甲噁唑的不敏感率也明显高于PSSP;19群的PNSP红霉素和四环素不敏感率明显高于PSSP,氯霉素耐药率明显低于PSSP;23、6、14和其他少见血清型/群菌株PNSP和PSSP之间,各抗菌药物不敏感率差异并无统计学意义。结论常见的19、23、6和14型/群肺炎链球菌对红霉素、复方磺胺甲噁唑和四环素耐药率高于其他少见血清型和不能分型菌株,PNSP与PSSP对部分非β内酰胺类抗生素不敏感率的差异可能与血清型分布有关。Objective To investigate the susceptibility of Streptococcus pneumoniae to non β-lactam antibiotics by serotype. Methods The 625 strains were isolated from out-patients with upper respiratory infection in Beijing, Shanghai and Guangzhou, 2000-2002. Antibiotic susceptibility was determined by E-test for erythromycin and penicillin and by disk diffusion method for tetracycline, sulfamethoxazole-trimethoprim and chloramphenicol. Results A total of 625 pneumococal strains were typed. The common types were serotypes 19, 23, 6 and 14. The nonsusceptible rates to erythromycin, tetracycline or sulfamethoxazoletrimethoprim in common-type group were significantly higher than in the other types and nontypable group. Nonsusceptible rates of penicillin nonsusceptible S. pneurnoniae （PNSP） to erythromycin and sulfamethoxazole-trimethoprim were significantly higher than those of penicillin susceptible S. pneurnoniae （PSSP）. In the nontypable group, nonsusceptible rates of PNSP to erythromycin and sulfamethoxazole-trimethoprim were also significantly higher than those of PSSP. Meanwhile, nonsusceptible rates of PNSP to erythromycin and tetracycline were significantly higher than those of PSSP in serotype 19; while the resistant rate to chloramphenicol was significantly lower. No similar association was found in serotype 23, 6 or 14. Conclusions The resistance rates to erythromycin, tetracycline and sulfamethoxazole trimethoprim are very high for serotypes 19, 23, 6 and 14 pneumococcal strains. The rates to some non β-1actam difference of nonsusceptibility antibiotics between PNSP and PSSP may be influenced by serotype distribution.

关 键 词：肺炎链球菌 血清分型 抗生素耐药性 儿童 

分 类 号：R446.5[医药卫生—诊断学]