2010-2015年珠海地区下呼吸道感染住院患儿肺炎链球菌耐药性分析

摘要

Objective To investigate the antimicrobial resistance of streptococcus pneumoninae in children of lower respira-tory infection in Zhuhai area, and to provide guidance for medication. Methods A total of 837 streptococcus pneumoninae strains were collected from children hospitalized of lower respiratory infection in our hospital during January 2010 to Jan-uary 2015. The K-B and E-test was used to determine the resistance to 13 antibiotics. Results The no susceptibility rate of the 837 strains to penicillin-G, amoxicillin, cefotaxine-Na,was 21.1%,33.3%,66.7%, and the resistance rate of them was 7.6%,11.1%,28.6%, respectively. The resistance rate of 837 strains to erythromycin, clarithromycin, clindamycin, compound sulfamethoxazole, tetracycline, was 96.8%, 96.6%, 93.0%, 72.5%, 83.8%, respectively. The susceptibility rate to rifampicin, chloramphenicol,ofloxacin, vamowycin, linezolid, was 97.4%,98.4%,100%,100%,100%,respectively. The resistance rate of the streptococcus pneumoninae strains to amoxicillin, cefotaxine-Na,erythromycin,clarithromycin, clindamycin, compound sulfamethoxazole, tetracycline, was more higher as streptococcus pneumoninae resistant to penicillin-G.The resistance rate of the 837 strains to penicillin-G, amoxicillin, cefotaxine-Na,increased from 6.9%,7.2%,19.2%, 8.7%,13.7%,34.9%, re-spectively during January 2010 to January 2015,but it was no different to other 10 antibiotics. Conclusion The resistant of Streptococcus pneumoninae in children hospitalized of lower respiratory infection in zhuhai are very high to commonly used antibiotics,and was different with Guangzhou,shenzhen,wuhan,etal. So we should pay more attention to it,and ongoing surveillance study on the antimiembial resistance of streptococcus pneumoninae is necessary for appropriate antimicrobial use and protect in pediatric clinical work.%目的：明确珠海地区下呼吸道感染住院患儿肺炎链球菌(Streptococcus pneumoniae，SP)的耐药情况，为临床治疗提供参考依据。方法收集2010年1月—2015年1月下呼吸道感染住院患儿痰标本分离到的837株SP，采用K-B法及E-test法检测菌株对13种抗菌药的敏感性。结果837株SP对青霉素G、阿莫西林、头孢噻肟钠的不敏感率分别为21.1%、33.3%、66.7%，其中耐药率分别为7.6%、11.1%、28.6%；对红霉素、克拉霉素、克林霉素、复方新诺明、四环素的耐药率分别达96.8%、96.6%、93.0%、72.5%、83.8%；而对利福平、氯霉素、左旋氧氟沙星、万古霉素、利奈唑胺的敏感率分别为97.4%、98.4%、100%、100%、100%。当SP耐青霉素G时，对阿莫西林、头孢噻肟钠、红霉素、克拉霉素、克林霉素、复方新诺明、四环素的耐药率也明显增加；5年间，SP对青霉素G、阿莫西林、头孢噻肟钠的耐药率分别从2010年的6.9%、7.2%、19.2%增加到2015年的8.7%、13.7%、34.9%，对其它10种药物的耐药性差异无统计学意义。结论珠海地区下呼吸道感染住院患儿SP对常用抗菌素的耐药情况较为严重，且与广州、深圳、武汉等地存在差异，应加强SP耐药性监测，保护性、合理使用抗菌素。