学龄前儿童下呼吸道感染肺炎链球菌的流行病学特征与耐药性变迁  

Epidemiological characteristics and drug resistance changes of Streptococcus pneumoniae in lower respiratory tract infection of preschool children

作　　者：王利民[1] 吴俊琪[1] 方寅飞 

机构地区：[1]金华市中心医院检验科,浙江金华321000

出　　处：《中国卫生检验杂志》2016年第9期1349-1352,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的了解学龄前儿童下呼吸道感染肺炎链球菌的流行病学特征及耐药性变迁情况,为临床诊断和治疗该菌感染提供依据。方法回顾性分析2011年1月-2015年12月自本院下呼吸道感染患儿分离的肺炎链球菌302例,利用WHONET 5.6软件分析药敏试验数据。结果肺炎链球菌的阳性率为9.1%,各年度感染肺炎链球菌患儿构成比呈逐年增加趋势,0岁～2岁患儿肺炎链球菌构成比显著高于其他年龄段,冬季构成比高于其他季节,差异均有统计学意义（P〈0.05）。血清学分型以19F为主,占65.7%,5年间肺炎链球菌对常用抗菌药物的耐药率呈普遍增长趋势,对复方新诺明、克林霉素、红环素的总耐药率较高,分别为80.1%、73.8%、69.5%,未发现对万古霉素、氯霉素、利奈唑胺耐药的菌株。结论肺炎链球菌的感染率可能与年龄、季节等因素相关,血清学分型以19F为主,对临床常用抗生素的耐药率呈逐年上升趋势。Objective To investigate the epidemiological characteristics and drug resistance of Streptococcus pneumoniae in the lower respiratory tract of the preschool children,in order to provide evidence for the clinical diagnosis and treatment of the infection. Methods Retrospective analysis of 302 cases of Streptococcus pneumoniae isolated from patients with lower respiratory tract infection during January 2011- December 2015,and WHONET 5. 6 software was used for the analysis of drug sensitivity test data. Results The positive rate of Streptococcus pneumoniae was 9. 1%,and the proportion of children infected with Streptococcus pneumoniae was increasing year by year,and that of the age ranged from 0 to 2 years old children with Streptococcus pneumoniae was significantly higher than other age groups,the constituent ratio in winter was higher than other seasons,with the differences statistically significant（ P 〈0. 05）. 19 F was the main type,accounting for 65. 7%,5 years of the resistance rate of Streptococcus pneumoniae to commonly used antimicrobial agents was generally increasing,which were highly resistant to cotrimoxazole,clindamycin,doxycycline respectively accounting for 80. 1%,73. 8%,69. 5%,and no resistance to chloramphenicol,vancomycin and linezolid were found. Conclusion The infection rate of Streptococcus pneumoniae may be related to age,season and other factors,with 19 F as the dominant,and the drug resistance rate of common antibiotics in clinic is increasing yearly.

关 键 词：肺炎链球菌 学龄前儿童 下呼吸道感染 流行病学 耐药性 

分 类 号：R725.6[医药卫生—儿科]