2021—2022年银川市三家医院肺炎链球菌临床分布及耐药性分析  

Analysis of clinical distribution and drug resistance to Streptococcus pneumonia in three hospitals of Yinchuan from 2021 to 2022

作　　者：樊瑞军[1] 张立平[1] 丁风琴 谢丽丽 张新霞 左兴智 董晓微[1] FAN Ruijun;ZHANG Liping;DING Fengqin;XIE Lili;ZHANG Xinxia;ZUO Xingzhi;DONG Xiaowei(Department of Clinical Laboratory,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院临床医学检验诊断中心,宁夏银川750002

出　　处：《宁夏医学杂志》2023年第10期914-917,共4页Ningxia Medical Journal

基　　金：国家科技基础资源调查专项基金项目(2019FY101208)。

摘　　要：目的 收集肺炎链球菌感染患者的临床信息、实验室检测数据及药敏结果进行研究,了解肺炎链球菌感染的临床特点和耐药性,为临床诊治提供科学依据。方法 收集银川市三家三级医院临床分离的非重复的肺炎链球菌菌株,选择年龄≥65岁和年龄≤5岁患者的痰液标本;其余标本年龄没有限制,同时整理患者的住院信息资料。细菌鉴定仪器为全自动细菌鉴定药敏分析仪(VITEK 2 Compact),药敏实验使用分析仪配套的药敏卡及E-test完成,对药敏结果进行数据分析。结果 一共收集临床分离肺炎链球菌130株,其中对青霉素敏感的肺炎链球菌(PSSP)118株,占比90.8%,对青霉素耐药的肺炎链球菌(PRSP)5株,占比3.8%,占比较少;对青霉素处于中介的肺炎链球菌(PISP)7株,占比5.4%;对青霉素敏感菌株占比较高;对红霉素和克林霉素及四环素的耐药率高达80%以上。对左氧氟沙星和莫西沙星呈现高度敏感性,万古霉素和利奈唑胺未见耐药的菌株。标本采集自呼吸内科、儿科和重症监护病房(ICU),这些菌株主要从痰液、肺泡灌洗液、血液和其他标本中分离出来。结论 银川市肺炎链球菌中PRSP菌株检出率高于2020年中国细菌耐药监测报告中的平均值(0.65%)。肺炎链球菌感染者经临床合理诊治预后较好,所以临床感染患者应尽早规范采集标本及时送检进行细菌培养,明确病原菌,准确诊断,根据药敏结果尽早进行及时规范治疗。Objective To collect clinical information,laboratory test data and drug susceptibility results of patients with streptococcus pneumoniae infection for analysis and research,to consider the clinical features and drug resistance of streptococcus pneumoniae infection,and provide scientific data for clinical diagnosis and treatment to various patients.Methods Clinical analysis of nonreplicating streptococcus pneumoniae isolated from three tertiary hospitals in Yinchuan City were collected,and the sputum samples were selected from the patients aged ≥65 years and ≤5 years old. There was no limit on the age of the remaining specimens,and the hospitalization information of patients was compiled. The bacterial identification was accomplished with the automatic bacterial detector (VITEK 2 Compact). The drug susceptibility test was carried out with the drug susceptibility card as well as E-test strip equipped with the tester,and the drug resistance data analysis was carried out on the drug susceptibility results. Results A total of 130 strains of streptococcus pneumoniae were collected clinically,of which 118 strains were sensitive to penicillin (PSSP),accounting for 90.8%,and 5 strains were resistant to penicillin (PRSP),accounting for 3.8%. 7 strains of penicillin intermediate streptococcus pneumoniae (PISP) accounted for 5.4%. The proportion of penicillin-sensitive strains was relatively high. The resistance rates to erythromycin,clindamycin and tetracycline were extremely up to 80%. Levofloxacin and moxifloxacin were highly sensitive,and the resistant strains were not seen in vancomycin and linezolid. The specimens were totally collected from respiratory,pediatric,and intensive care units (ICUs). These strains were primarily obtained from sputum,bronchial lavage,blood and other specimens. Conclusion The detection rate of PRSP strain in streptococcus pneumoniae in this city is higher than the average value(0.65%) in the 2020 Chinese bacterial resistance surveillance report. The patients with streptococcus pneumoniae

关 键 词：肺炎链球菌 临床资料 感染现状 耐药 

分 类 号：R446.5[医药卫生—诊断学]