ICU医院感染肺炎链球菌的耐药性分析  

Drug resistance of Streptococcus pneumoniae causing nosocomial infections in ICU

作　　者：张勇昌[1] 赖伟忠[1] 陈月新[1] 罗晓[1] 

机构地区：[1]玉林市第一人民医院检验科,广西玉林537000

出　　处：《中华医院感染学杂志》2013年第21期5316-5317,5320,共3页Chinese Journal of Nosocomiology

基　　金：玉林市科技基金项目(13036006)

摘　　要：目的探讨ICU患者医院感染肺炎链球菌的耐药性,为临床用药提供依据。方法采用法国生物梅里埃公司的VITEK-2Compact全自动细菌鉴定仪对2008年1月-2012年5月ICU住院患者痰标本分离鉴定肺炎链球菌52株,并进行药物药敏试验,对药敏结果进行统计分析。结果 ICU住院患者分离52株肺炎链球菌,医院感染肺炎链球菌占检出肺炎链球菌65.38%;医院感染肺炎链球菌对青霉素耐药率为88.24%,对红霉素、四环素、磺胺甲噁唑/甲氧苄啶的耐药率均为100.00%,对阿莫西林及头孢噻肟为52.94%及47.06%,对氯霉素、左氧氟沙星、氧氟沙星、莫西沙星的耐药率分别为2.94%、8.82%、14.71%、8.82%,而对利奈唑胺及万古霉素暂无耐药性;医院感染肺炎链球菌对青霉素、阿莫西林、头孢噻肟、红霉素、四环素、磺胺甲噁唑/甲氧苄啶的耐药率高于非医院感染肺炎链球菌,差异有统计学意义(P<0.05)。结论 ICU医院感染肺炎链球菌对多种抗菌药物的耐药率较高,临床治疗应减少经验性用药,建议依据药敏结果选择抗菌药物进行治疗。OBJECTIVE To discuss the drug resistance of Streptococcus pneumoniae causing nosocomial infections in the patients of ICU so as to provide guidance for clinical medication. METHODS Totally 52 strains of S. pneumoniae isolated from sputum specimens which were obtained from the patients who were hospitalized in the ICU from Jan 2008 to May 2012 were identified with the use of VITEK-2 Compact of Biomeriex, France, then the drug susceptibility testing was performed, and the result of the drug susceptibility testing was statistically analyzed. RESULTS Of totally 52 strains of S. pneumoniae isolated from ICU hospitalized patients, 65. 38% caused nosocomial infections. The drug resistance rate of the S. pneumoniae to penicillin was 88. 24%, the drug resistance rates to erythromycin, tetracycline, and sulfamethoxazole-trimethoprim were 100. 00%, the drug resistance rates to amoxicillin and cefotaxime sodium were 52.94% and 47.06%, respectively, the drug resistance rates to chloramphenicol, levofloxacin, ofloxacin, and moxifloxacin were 2.94 %, 8.82%, 14.71 %, and 8.82%, respectively, and the drug resistance rates to linezolid and vancomycin were 0; the drug resistance rates of the S. pneumoniae strains causing nosocomial infections to penicillin, amoxicilin, cefotaxime sodium, erythromycin, tetracycline, and sulfamethoxazole-trimethoprim were higher than those of the strains that did not cause nosocomial infections. CONCLUSION The S. pneumoniae strains causing nosocomial infections in the ICU are highly resistant to many antibacterial agents, it is suggested that the empirical medication should be reduced during the clinical treatment and the antibiotics should be used based on the result of drug susceptibility testing.

关 键 词：肺炎链球菌 耐药性 医院感染 

分 类 号：R378.12[医药卫生—病原生物学]