儿童呼吸道感染肺炎链球菌的耐药性分析  

Drug resistance of Streptococcus pneumoniae causing respiratory tract infection in children

作　　者：金国强[1] 吴俭[2] 陈晓[2] 刘赟[2] 余伟[2] 

机构地区：[1] 南昌大学第一附属医院保健科 [2]南昌大学第一附属医院 儿科,江西南昌330006

出　　处：《中华医院感染学杂志》2014年第18期4452-4454,共3页Chinese Journal of Nosocomiology

基　　金：江西省教育厅基金资助项目(GJJ12095)

摘　　要：目的探讨医院儿童呼吸道感染肺炎链球菌的耐药性,以期对临床合理使用抗菌药物提供依据。方法选取医院2011年8月-2014年2月收治的5 060例呼吸道感染患儿,取其痰液标本进行培养,观察肺炎链球菌的检出率;通过药敏分析调查肺炎链球菌对抗菌药物的耐药性;对青霉素敏感的肺炎链球菌(PSSP)和耐药(PRSP)菌株对不同抗菌药物的耐药率进行了比较。结果 5 060例呼吸道感染的患儿中有400例患儿检出肺炎链球菌,检出率为7.91%;肺炎链球菌对红霉素、四环素、克林霉素、磺胺甲噁唑/甲氧苄啶的耐药率较高,均≥85.00%;对氯霉素、头孢克洛和头孢呋辛较敏感,敏感率≥78.00%;同时肺炎链球菌对万古霉素、左氧氟沙星和阿莫西林/克拉维酸高度敏感,敏感率均为100.00%,PRSP对β-内酰胺类、红霉素、磺胺甲噁唑/甲氧苄啶、喹诺酮类的耐药率均显著高于PSSP,差异有统计学意义(P<0.05);PRSP的多药耐药率为90.63%,PSSP为54.93%,差异有统计学意义(P<0.05)。结论医院儿童呼吸道感染肺炎链球菌耐药形势严峻,临床治疗中应严格按照药敏试验结果合理使用抗菌药物,以利于患儿的早日康复。OBJECTIVE To explore the drug resistance of Streptococcus pneumoniae causing respiratory tract infec-tion in children so as to provide guidance for reasonable clinical use of antibiotics .METHODS A total of 5 060 chil-dren with respiratory tract infection ,who were treated in the hospital from Aug 2011 to Feb 2014 ,were enrolled in the study ,then the sputum specimens were collected and cultured ,and the isolation rate of S .pneumoniae was observed ;the drug susceptibility testing was performed to analyze the drug resistance of S .pneumoniae ,and the drug resistance rates of the penicillin-sensitive S .pneumoniae （PSSP ） and penicillin-resistant S .pneumoniae （PRSP） to various antibiotics were observed and compared .RESULTS Of 5 060 children with respiratory tract in-fection ,400 children were detected positive for S .pneumoniae with the detection rate of 7 .91% .The drug resist-ance rates of the S .pneumoniae to erythromycin ,tetracycline ,clindamycin ,and trimethoprim-sulfamethoxazole were no less than 85 .00% ,the drug susceptibility rates to chloramphenicol ,cefaclorand ,and cefuroxime were no less than 78 .00% ;the S .pneumoniae strains were highly susceptible to vancomycin ,levofloxacin ,and amoxicil-lin/clavulanic acid ,with the drug susceptibility rates of 100 .00% ;the drug resistance rates of the PRSP to β-lac-tams ,erythromycin ,trimethoprim-sulfamethoxazole ,and quinolones were significantly higher than those of the PSSP ,there was significant difference （P〈0 .05）;the multidrug-resistant rate of the PRSP strains was 90 .63% , the PSSP strains 54 .93% ,with statistical significance （P〈0 .05） .CONCLUSION The situation of drug resistance of the S .pneumoniae causing respiratory tract infection in the children is harsh ;it is necessary to reasonably use antibiotics during the clinical treatment according to the results of the drug susceptibility testing so as to promote the early recovery of the children .

关 键 词：儿童呼吸道感染 肺炎链球菌 耐药性分析 

分 类 号：R378[医药卫生—病原生物学]