肺炎链球菌的耐药性监测  

Monitoring of antimicrobial resistance of Streptococcus pneumoniae

作　　者：闵小春[1] 罗少锋[1] 伍婷婷[1] 王威[1] 刘东华[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院检验科,湖北武汉430033 [2]孝感市中心医院检验科,湖北孝感432000

出　　处：《中华医院感染学杂志》2014年第13期3149-3151,共3页Chinese Journal of Nosocomiology

基　　金：湖北省科技厅自然科学基金资助项目(2012FFC120)

摘　　要：目的了解临床分离肺炎链球菌（SPN）的分布及标本来源特点并监测其耐药性,与国内外耐药监测数据进行差异性比较,为有效抗感染提供参考依据。方法收集2011年1月1日-2013年3月31日临床分离的348株肺炎链球菌,采用E-test法检测其对青霉素和头孢曲松的MIC值,其余抗菌药物均采用K-B法进行药敏试验;采用WHONET5.6软件进行统计分析。结果 348株肺炎链球菌有196株分离自儿科病房,占56.3%,有341株肺炎链球菌来自呼吸道标本,占98.0%;青霉素不敏感肺炎链球菌（PNSP）检出率为3.5%,耐青霉素肺炎链球菌（PRSP）的检出率为0.6%;肺炎链球菌对青霉素、头孢曲松、氟喹诺酮类药物的敏感率在81.3%～98.9%,肺炎链球菌对红霉素和克林霉素敏感率最低,〈4.0%。结论肺炎链球菌对红霉素、克林霉素耐药严重,对青霉素、头孢曲松及氟喹诺酮类抗菌药物仍保持较高的敏感性,建议在肺炎链球菌感染早期积极送检血培养标本,以提高该病原菌的检出率,同时应重视细菌耐药性监测,根据药敏试验结果合理选用抗菌药物。OBJECTIVE To understand the distribution of clinical isolates of Streptococcus pneumoniae, analyze the characteristics of specimen sources, monitor the drug resistance, and compare with the surveillance data both in China and abroad so as to provide guidance for effective control of infections. METHODS From Jan 1, 2011 4o Mar 31, 2013, totally 348 clinical isolates of S. pneumoniae were collected, then the MIC values to penicillin and ceftri- axone were determined with the use of E-test method, the drug susceptibility testing was performed for other anti- biotics by using K-B method, and the statistical analysis was performed with the use of WHONET5.6 software. RESULTS Of the 348 strains of S. pneumoniae, 196 （56.3M） strains were isolated from the wards of pediatrics department, and 341 （98.0%） strains were isolated from respiratory tract specimens. The isolation rate of penicil- lin-non-susceptible S. pneurnoniae was 3. 5%, and the isolation rate of penicillin-resistant S. pneumoniae was 0.6%. The drug susceptibility rates of the S. pneumoniae to penicillin, ceftriaxone, and fluoroquinolone varied from 81.3% to 98.9%, and the drug susceptibility rates of the S. pneumoniae to erythromycin and clindamycin were the lowest （less than 4.0%）. CONCLUSION The S. pneumoniae strains are highly resistant to erythromycin and clindamycin and remain highly susceptible to penicillin, ceftriaxone, and fluoroquinolone. It is suggested that the blood culture specimens should be submitted in early stage of the S. pneumoniae infection to increase the isola- tion rate of the pathogens and that great attention should be paid to the bacterial drug resistance so as to reasonably use antibiotics based on the result of drug susceptibility testing.

关 键 词：肺炎链球菌 抗菌药物 药敏试验 耐药性 

分 类 号：R378[医药卫生—病原生物学]