摘要
目的分析海南地区老年患者肺炎链球菌感染的临床分离情况及其耐药性,为临床诊断和治疗提供依据。方法收集海南地区2010—2012年住院老年患者临床送检标本3 052份,共分离不重复肺炎链球菌225株,药敏试验采用梅里埃VITEK 2 compact肺炎链球菌药敏卡(AST-GP68)检测,结果按临床实验室标准协会(CLSI)2012年版标准判读,采用WHONET 5.6软件进行耐药性分析。结果 225株肺炎链球菌在痰液、胸腹腔积液、血液及脑脊液中的检出率分别为9.3%(213/2 291)、4.2%(5/120)、0.6%(3/506)、1.5%(1/65),差异有统计学意义(P<0.01)。该菌对青霉素的耐药率为30.2%,对红霉素、四环素和复方新诺明的耐药率分别为85.3%、84.4%和61.3%,对头孢他啶、美罗培南、厄他培南、氯霉素、左氧氟沙星和氧氟沙星的耐药率在20%左右,未发现对利奈唑胺、万古霉素、莫西沙星的耐药菌株。结论肺炎链球菌是老年患者感染的主要致病菌,主要检出于痰标本,青霉素作为该菌治疗的首选药物,其耐药率的增高应引起重视。
Objective To investigate the antimicrobial susceptibility and clinical characteristics of S.pneumoniae isolated from elderly patients in Hainan Province.Methods A total of 225 S.pneumoniae strains were isolated from 3 052 clinical specimens of elderly inpatients in Hainan during 2010—2012.The antibiotics susceptibility of these strains was measured with VITEK 2 AST-GP68 Test Kit,interpreted with the 2012 Standards by Clinical and Laboratory Standard Institute,and analyzed with WHONET 5.6 software.Results The detection rates of S.pneumoniae from sputum,pleural effusion,blood,and cerebrospinal fluid were 9.3%（213/2 291）,4.2%（5/120）,0.6%（3/506）,and 1.5%（1/65）,which were significantly different（P 0.01）.The assay showed that 30.2%,85.3%,84.4%,and 61.3% of the isolates exhibited resistance to penicillin,erythromycin,tetracycline,and SMZ-TMP,respectively.The resistance rates to other antibiotic agents such as ceftazidime,meropenem,ertapenem,chloromycetin,levofloxacin,and ofloxacin were about 20%.No linezolid,vancomycin,or moxifloxacin resistant strain was found.Conclusion S.pneumoniae is a major cause of bacterial infections in the elderly patients,which was mainly detected in sputum.Penicillin is the first-choice drug for combating S.pneumonia.However,the increasing resistance rate of S.pneumoniae against penicillin requires more attention.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第22期2647-2649,共3页
Chinese General Practice
关键词
肺炎球菌感染
老年患者
临床分布
耐药性
Pneumococcal infections
Elderly patients
Clinical distribution
Drug resistance
