南京某综合性医院成人感染肺炎链球菌的临床特征与耐药性分析  

An Analysis of Clinical Characteristics and Drug Resistance of Streptococcus Pneumoniae Infection in Adults in a General Hospital in Nanjing Area,China

作　　者：蔡兴龙 周万青[1] 张燕[1] 纪玥玥 王丹微 沈瀚[1] CAI Xinglong;ZHOU Wanqing;ZHANG Yan;JI Yueyue;WANG Danwei;SHEN Han(Department of Laboratory Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of NanjingUniversity Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院检验科,江苏南京210008

出　　处：《标记免疫分析与临床》2024年第2期228-231,281,共5页Labeled Immunoassays and Clinical Medicine

基　　金：南京市医学科技发展资金项目(编号:QRX17143)。

摘　　要：目的了解综合性医院成人感染肺炎链球菌的相关临床特征和药物敏感性情况,为临床合理用药提供依据。方法收集南京鼓楼医院2020年4月至2022年6月住院和门诊成人分离出肺炎链球菌,采用梅里埃VITEK微生物鉴定系统对菌株进行鉴定,并使用GP68卡或K-B法进行抗菌药物敏感性试验;通过回顾性分析患者相关临床资料并做整理分析。结果77例成人感染肺炎链球菌年龄为59.0(50.5,70.0)岁,冬季和春季分离占比分别为41.56%和32.47%;标本类型分别为痰液59.74%、灌洗液14.29%和分泌物12.99%;科室分布为耳鼻咽喉科15.58%、呼吸与危重科15.58%、心胸外科15.58%。77株肺炎链球菌青霉素耐药株(PRSP)为25.97%,对红霉素、克林霉素、四环素的耐药率分别为97.26%、88.89%、80.26%。对万古霉素、利奈唑胺、泰利霉素敏感率均为100%。结论成人感染肺炎链球菌主要发生在冬春季节,中老年人易感。肺炎链球菌对大环内酯类和四环素耐药率高,不宜经验性应用,临床应积极送检微生物标本,根据药敏结果使用抗菌药物。Objective To investigate the clinical characteristics and drug sensitivity of adults infected with S.pneumoniae in a general hospital,and to provide evidences for clinical rational drug use.Methods S.pneumoniae was isolated from both inpatients and outpatients in Nanjing Drum Tower Hospital from April,2020 to June,2022.The strains were identified by the Bio Mérieux VITEK microbial identification system,and GP68 card or K-B method was used to test the antimicrobial susceptibility.The relevant clinical data of studied patients were analyzed retrospectively and sorted out.Results The mean age of 77 adults infected with S.pneumoniae was 59.0(50.5,70.0)years old,and the proportion of separation in winter and spring was 41.56%and 32.47%,respectively.The specimen types were:sputum 59.74%,lavage 14.29%and secretions 12.99%,respectively.The department distribution was:Otorhinolaryngology 15.58%,Respiratory and Critical care 15.58%,Cardiothoracic Surgery 15.58%.77 strains of S.pneumonia penicillin-resistant strains(PRSP)accounted for 25.97%,and the resistance rates to erythromycin,clindamycin and tetracycline were 97.26%,88.89%and 80.26%,respectively.The susceptibility rate to vancomycin,linezolid and telithromycin was 100%.Conclusion Adult infection with S.pneumoniae mainly occurs in winter and spring,and middle-aged and elderly people were more susceptible.S.pneumoniae has a high resistance rate to macrolides and tetracycline,so it is not suitable for empirical application.In clinical practice,microbial samples should be actively tested,and antibiotics should be used according to the drug sensitivity results.

关 键 词：成人 肺炎链球菌 临床特征 耐药性 

分 类 号：R378.12[医药卫生—病原生物学]