摘要
目的对儿童肺炎链球菌的临床分布和耐药性进行分析,了解常见药物的耐药性变化情况,为临床合理用药提供依据。方法统计分析广州市妇女儿童医疗中心2014年1月至2015年12月分离培养的肺炎链球菌临床分布状况,E-test测定青霉素最低抑菌浓度(MIC),其余药物的MIC通过VITEC 2测定,采用χ~2检验进行耐药性分析。结果儿科患者分离培养肺炎链球菌1 361例,多为5岁以下儿童,标本来源主要为痰液,临床诊断主要为肺炎/支气管肺炎。肺炎链球菌对四环素和红霉素耐药率分别为94.1%和97.3%,万古霉素和利奈唑烷全敏感,泰利霉素在侵袭性感染和非侵袭性感染中的耐药率差异有统计学意义(P<0.05)。青霉素耐药率为11.4%,其在MIC≤0.5μg/ml时β内酰胺类药物的敏感性高达98.3%。青霉素敏感的肺炎链球菌和耐青霉素的肺炎链球菌其多重耐药检出率分别为65.2%和98.7%,二者差异有统计学意义(χ~2=71.142,P<0.05)。结论为最大限度降低细菌的耐药性,临床医生应参考体外药敏试验结果合理选择使用抗生素。
Objective This study was conducted to analysis the clinical distribution and drug-resistance of Streptococcus pneumoniae isolated from infected children,and understand the changes of common drug resistance in recent years,and provide a basis for clinical rational drug use. Methods The clinical distribution of Streptococcus pneumoniae in Guangzhou Women and Children′s Medical Center from 2014 to 2015 were analyzed in this study; the susceptibility to penicillin was determined by E-test and the others by VITEC 2. The drug resistance was analyzed by chi-square test. Results 1 361 strains of Streptococcus pneumoniae were isolated from children mostly under the age of five years old. The isolates were mainly from the sputum. The clinical diagnosis of the patients was mainly of pneumonia/bronchial pneumonia. The drug- resistance rates of tetracycline and erythromycin were 94.1% and 97.3%,respectively. All the strains were sensitive to Vancomycin and Linezolid. Telithromycin resistance rates of noninvasive and invasive infection were significantly different（P〈0.05）. The drug-resistance rate of penicillin was 11.4%. The drug susceptibility of β-lactams was 98.3% with a penicillin MIC of ≤0.5μg/ml. The multi-drug resistance rates of penicillin-resistant Streptococcus pneumoniae and penicillin-resistant Streptococcus pneumoniae were 65.2% and 98.7%,respectively,with a significant difference（χ^2=71.142,P〈0.05）. Conclusion In order to reduce the rates of bacteria resistance,clinicians should refer to the results of drug sensitivity test for the selection of antibiotics.
出处
《热带医学杂志》
CAS
2017年第1期49-52,共4页
Journal of Tropical Medicine
基金
广东省科技计划项目(2015A030401007)
关键词
儿童
肺炎链球菌
抗菌药物
耐药性
Children
Streptococcus pneumoniae
Antibiotics
Drug resistance
