儿童呼吸道肺炎链球菌和金黄色萄萄球菌的耐药性研究  

Antibiotic resistance of Streptococcus pneumoniae and Staphylococcus aureus isolates from children′s throat swab and sputum

作　　者：邱素清[1] 向华国 蒲荣 

机构地区：[1]深圳市宝安区人民医院,广东深圳518101 [2]深圳市宝安区福永人民医院,广东深圳518103 [3]东莞市寮步医院,广东东莞523400

出　　处：《中国微生态学杂志》2011年第11期1011-1012,共2页Chinese Journal of Microecology

摘　　要：目的了解儿童感染肺炎链球菌和金黄色萄萄球菌耐药情况,为临床合理用药提供理论依据。方法对年龄为1个月～12岁的上呼吸道感染的儿童鼻咽分泌物或痰进行培养,分离肺炎链球菌和金黄色萄萄球菌;采用纸片扩散法及E-test法对分离株进行常用的10种抗生素敏感性检测。结果从2 250例呼吸道感染儿童鼻咽部、痰液分离出肺炎链球菌共120株,金黄色葡萄球菌共151株。120株肺炎链球菌对常用抗菌药物耐药率分别为青霉素41.7%(50/120)、苯唑西林26.7%(32/120)、头孢曲松9.2%(11/120)、红霉素95.8%(115/120)、克林霉素90.0%(108/120)、四环素70.8%(85/120)、氯霉素6.7%(8/120)、利福平0.8%(1/120)和氧氟沙星0.8%(1/120),肺炎链球菌青霉素不敏感株对β-内酰胺酶类耐药率明显高于青霉素敏感株。151株金黄色葡萄球菌中对常用抗菌药物耐药率分别为青霉素97.4%(147/151)、苯唑西林9.9%(15/151)、头孢曲松9.3%(14/151),对红霉素52.3%(79/151)、四环素31.8%(48/151)、克林霉素24.5%(37/151)、氯霉素9.9%(15/151)、氧氟沙星3.3%(5/151)和利福平2.0%(3/151)。未检出耐万古霉素菌株。结论肺炎链球菌对红霉素、克林霉素高度耐药;而金黄色葡萄球菌对青霉素高度耐药,临床应尽量减少此类药物的经验性用药,依据药敏结果选择抗菌药物进行治疗。Objective To investigate the drug resistance of Streptococcus pneumoniae （SP） and Staphylococcus aureus isolated from children in order to provide clinical guidelines for the rational using of antimicrohial drugs. Method The Sp and Staphylococcus aureus were cultured, isolated and identified from throat swabs or sputum specimens of children aging 1 month to 12 years with respiratory inteetion. Kirby-Bauer disc diffusion and E-test for antibiotic susceptibility were per- formed for these clinical isolates. Result Totally 120 and 151 strains of SP and Staphylococcus aureus were respectively isclated from throat swabs and sputa. For SP strains, the rates of resistance to penicillin, oxacillin, ceftriaxone, erythromycin, elindamycin, tetracycline, chloranaphenicol, ofloxacin, rifampicin were 41.7%, 26.7%, 9.2%, 95.8%, 90.0%, 70.8%, 6.7%, O. 8% and 0.8% respectively. The non-penicillin-susceptible SP （NPSSP） isolates showed higher rates of resistance to β-lactamase antimicrobial agents than penicillin susceptible SP （PSSP） isolates. For Staphylococcus aureus, the rates of resistance to penicillin, oxacillin, eeftriaxone, erythromycin, elindamycin, tetracycline, ehloramphenicol, ofloxacin, rifampicin were 97.4%, 9.9%, 9.3%, 52.3%, 31.8%, 24.5%, 9.9%, 3.3% and 2.0% respectively. Vancomycin-resistant strains were not found. Conclusion The SP isolates are highly resistant to erythromycin and clindamycin, while Staphylococcus aureus is highly resistant to penicillin. It is necessary to monitor resistance of SP and Staphylococcus aureus so as to provide clinical guidelines for the rational useing of antimicrobial agents.

关 键 词：肺炎链球菌 金黄色萄葡球菌 抗生素 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]