摘要
目的了解肺炎链球菌常见的感染类型、对药物的敏感性,为临床正确诊治提供循证依据。方法回顾分析本院2010年1月～2011年12月临床确诊为肺炎链球菌感染的病例,采用纸片扩散法检测左氧氟沙星、万古霉素、复方磺胺、红霉素、克林霉素的敏感性,E-test方法测试分离菌对青霉素的最低抑菌浓度(MIC),用Whonet5.5软件分析青霉素MIC的分布及MIC50和MIC90。结果共分离出肺炎链球菌96株,标本来源应以下呼吸道感染为主(81例84.4%),肺炎链球菌青霉素的MIC分布范围为(0.016～64)μg/ml,呼吸系统和血流感染静脉用青霉素的敏感率为97.5%(79/81)。结论肺炎链球菌感染以呼吸系统感染为主,感染人群以儿童为主,成人感染多并发肿瘤、COPD、风湿等基础疾病。呼吸、感染的肺炎链球菌对静脉用青霉素、万古霉素和左氧氟沙星保持较高的敏感性。影响治疗成败的关键因素是感染部位和治疗的及时性。
Objective To investigate the varieties of infections, susceptibilities of S. pneumoniae isolated from in- fected patients ,to find the leading causes of illness and treatment failures. Methods A retrospective analysis was made to the S. pneumoniae injected cases of our hospital from January 2010 to December 2011. The minimum inhibitory concentra- tions （MICs） of penicillin and zone diameter of other antimicrobial agents were determined by Etest and disk diffusion method respectively. WHONET5.5 software was used to analyze penicillin MICs distribution,MIC50 and MIC90. Results A total of 96 patients were infected by S. pneumoniae, of which respiratory system infections, bloodstream infections, centre nervous system infections,bloodstream and centre nervous system infections, intra-abdominal infections, thorax in- fection,septic thyroisitis and otitis media were the leading illness, accounting for 84.4%, 6.3%, 2.1% ,3.1%,1.0%, 1.0%, 1.0% and 1.0% respectively. Those patients included children and adults, accounting for 72.9%, 27. 1% respec- tively. Penicillin MICs distribution ranged from 0. 016 to 64 ug/ml, MICS0 2 /μg/ml,MIC90 2 μg/ml. Penicillin,van- comycin and leve-flocacin showed excellent activities against S. pneumoniae isolated from bloodstream and sputum, The ac-tivities of erythromycin, clindamycin, trimethoprln/suttameuJux~＇＂~ o^s ~ main varieties infections of S. pneumoniae were respiratory tract,bloodstream and centre nervous system infections. Chil- dren and adults who had underlying medical conditions such as active malignancies, COPD and rheumatism were the domi- nant persons suffered it. The main reason for failure to respond was progression of pathophysiological changes despite ap- propriate antibiotic treatment.
出处
《临床输血与检验》
CAS
2012年第4期319-321,共3页
Journal of Clinical Transfusion and Laboratory Medicine
关键词
肺炎链球菌
感染
耐药
Streptococcus pneumoniae Infection Resistance
