肺炎链球菌临床分布情况及药敏分析

摘要

目的 了解肺炎链球菌(SP)临床标本分布情况及药敏结果,对SP感染在临床诊断、治疗及预防提供依据.方法 将2010-2015年分离出的非重复菌株416株SP,采用ATB Express细菌鉴定系统进行鉴定及药敏试验,结果 按CLSI2014年版标准进行判读.结果 6年中,SP在冬春2季呈分离高峰;呼吸道标本检出达90％以上;以幼儿和老年人为主;对青霉素、阿莫西林等仍然保持高度敏感性,但其敏感率与非敏感率比较差异有统计学意义(P＜0.05);而克林霉素、红霉素等呈现高水平不敏感,其敏感率与非敏感率比较差异无统计学意义(P＞0.05).结论 虽然青霉素等β-内酰胺类抗菌药物仍可作为SP感染治疗的首选,但青霉素中介的SP(PISP)及耐青霉素的SP(PRSP)有逐年上升趋势;应根据药敏试验结果选择抗菌药物.%Objective To understand the clinical distribution situation of streptococcus penumoniae (SP) and drug susceptibility test results to provide a basis for the clinical diagnosis,treatment and prevention of SP infection.Methods Totally 416 nonrepeat strains of SP were isolated during 2010 to 2015.Their identification and drug susceptibility test were performed by using the ATB Express bacterial identification system.The results were interpreted according to the standard of CLSI 2014 edition.Results In these 6 years,SP showed the isolation peak in spring and winter;the detection rate of respiratory tract specimens reached more than 90 ％;the young children and elderly people were predominant;SP maintained high sensitivity to penicillin,amoxicillin,etc.,the difference in the sensitivity rate and non-sensitivity rate had statistical significance(P＜0.05);but SP showed high level non-sensitivity to clindamycin,erythromycin,etc.,the difference in the sensitivity rate and non-sensitivity rate had no statistical significance (P＞0.05).Conclusion Although β-lactam antibiotics such as penicillin can still be used as the first choice of therapy,but PISP and PRSP show the increasing trend year by year;therefore the antibacterial drugs should be selected according to the drug susceptibility test results.