漯河市某医院2018—2020年肺炎链球菌分布及药物敏感性监测  

Distribution and Drug Resistance of Streptococcus pneumoniae in a Hospital of Luohe City from 2018 to 2020

作　　者：李宁 马琼 张琦[2] 常军玲 王俊红[1] 孟艳平[1] 寇曦曦 朱俊民[1] 李轶[2] 曹兴华[1] Li Ning;Ma Qiong;Zhang Qi;Chang Jun-ling;Wang Jun-hong;Meng Yan-ping;Kou Xi-xi;Zhu Jun-min;Li Yi;Cao Xing-hua(Luohe Central Hospital,Luohe 462000;Henan Provincial People's Hospital,Zhengzhou 450003)

机构地区：[1]漯河市中心医院,河南漯河462000 [2]河南省人民医院,郑州450003

出　　处：《国外医药（抗生素分册）》2022年第2期141-145,共5页World Notes on Antibiotics

基　　金：河南省医学科技攻关计划项目(SBGJ2018084);河南省科技厅项目(编号192102310434,182102311241)。

摘　　要：目的了解漯河市中心医院2018—2020年临床分离肺炎链球菌分布特点及耐药情况,为当地临床经验用药提供依据。方法收集2018—2020年临床分离的非重复肺炎链球菌菌株,采用VITEK 2-Compact细菌自动鉴定仪和E试验条进行药物敏感性试验,按美国临床和实验室标准化协会(CLSI)2020年版标准判读结果。采用WHONET 5.6及SPSS26.0软件进行数据统计分析。结果共分离肺炎链球菌1588株,主要来源于痰液、全血、脑脊液(97.6%、1.5%、0.3%);幼儿占比83.3%(呈逐年递减趋势,P<0.001)、儿童占比10.9%,成人占比5.9%(逐年递增P<0.001);儿科和呼吸科占比分别呈逐年递减(P<0.001)和递增(P=0.003)趋势。四环素、复方磺胺甲恶唑、红霉素敏感率低(0.5%~14.7%);三代头孢菌素类敏感率呈下降趋势(98.9%~95.6%,P=0.001);氯霉素、左氧氟沙星敏感率较高(89.7%~99.5%);未检出耐青霉素、万古霉素、利奈唑胺的肺炎链球菌。痰液来源肺炎链球菌的复方磺胺甲恶唑敏感率低于血液来源(P=0.026);不同年龄组间左氧氟沙星和氯霉素敏感率呈下降趋势(P<0.001和P=0.036),四环素敏感率呈上升趋势(P=0.034)。结论肺炎链球菌在成年患者及呼吸科的检出率逐年增加,对三代头孢菌素类敏感率有逐年下降趋势,痰液分离菌株对复方磺胺甲恶唑的敏感率低于血液分离菌株,左氧氟沙星与氯霉素敏感率随年龄呈下降趋势、四环素敏感率随年龄呈上升趋势。Objective To understand the distribution characteristics and drug resistance of Streptococcus pneumoniae isolated from the Central Hospital of Luohe from 2018 to 2020,and provide the basis for local clinical experience.Methods The non repetitive Streptococcus pneumoniae strains isolated from clinical in 2018—2020 were collected.The drug sensitivity test was conducted by VITEK 2 compact bacterial automatic identification instrument and E-test strip.The results were judged according to the standards of CLSI 2020.The data were analyzed by WHONET 5.6 and spss26.0 software.Results 1588 strains of Streptococcus pneumoniae were isolated,mainly from sputum,whole blood and cerebrospinal fluid (97.6%,1.5%,0.3%).Kid accounted for 83.3% (showing a decreasing trend year by year,P < 0.001),and children accounted for 10.9%.The proportion of Pediatrics and respiratory department decreased year by year (P <0.001) and increased year by year (P=0.003).The sensitivity rates of tetracycline,sulfamethoxazole and erythromycin were low (0.5%~14.7%).The sensitivity rate of the third generation cephalosporins decreased (98.9%~95.6%,P=0.001).The sensitive rates of chloramphenicol and levofloxacin were 89.7%~99.5%.No Streptococcus pneumoniae resistant to penicillin,vancomycin and linezolid was detected.The sensitivity of Streptococcus pneumoniae from sputum was lower than that from blood (P=0.026).The sensitivity rates of levofloxacin and chloramphenicol decreased in different age groups (P<0.001 and P=0.036),while the sensitivity rate of tetracycline increased (P=0.034).Conclusion the detection rate of Streptococcus pneumoniae in adult patients and respiratory department increased year by year,and the sensitivity rate to the third generation cephalosporin decreased year by year.The sensitivity rate of compound sulfamethoxazole from sputum was lower than that from blood.The sensitivity rates of levofloxacin and chloramphenicol decreased with age,and the sensitivity rate of tetracycline increased with age.

关 键 词：肺炎链球菌 儿童 耐药性分析 

分 类 号：R978.1[医药卫生—药品]