儿童肺炎链球菌感染流行病学及耐药分析

摘要

Objective To investigate the clinical epidemiological trend and antibiotic resistance of Strepto-coccus pneamoniae isolated from infected children. Methods A total of 206 Streptococcus pneamoniae isolated from infected children in Xi'an Children's Hospital between March 1, 2013 and February 28, 2014 were collected, and epide-miological distribution of age and season were analyzed to achieve clinical epidemiology data of Streptococcus pneamoniae in infected children. Sensitivity of Streptococcus pneamoniae to penicillin, ceftriaxone and cefotaxime were determined by E-test, and sensitivity of Streptococcus pneamoniae to clindamycin, erythromycin and vancomycin were tested by K-B method. Results A total of 206 Streptococcus pneamoniae isolates were obtained, 146 of which were isolated from infected children under 2 years old, 46 from 2 to 5 years old, and 14 from 5 to 14 years old. 37 infec-tions occurred in spring, with 18 in summer, 49 in autumn, and 102 in winter. Drug sensitivity rates of penicillin, clinda-mycin, erythromycin, ceftriaxone, cefotaxime and vancomycin were 70%, 4%, 2%, 80%, 83%and 100%, respectively. Conclusion The majority of infected children were under 2 years old, and infections occur mostly in winter. penicillin is still the preferred drug for the treatment of common Streptococcus pneumoniae infection. The third generation cephalo-sporins can be used for penicillin non-sensitive treatment of Streptococcus pneumoniae infection. we do not find any van-comycin resistant strains. High prevalence of erythromycin and clindamycin resistance demonstrates that this two kinds of antibiotics is not suitable for the treatment of Streptococcus pneamoniae infection.%目的：了解肺炎链球菌流行及耐药情况，为肺炎链球菌的预防及临床合理用药提供依据。方法收集西安市儿童医院2013年3月至2014年2月分离的肺炎链球菌菌株，综合分析各年龄段、季节的感染情况，获得儿童感染肺炎链球菌流行病学资料。采用E-test法检测菌株对青霉素、头孢曲松、头孢噻肟的敏感性，采用纸片法检测菌株对克林霉素、红霉素、万古霉素的敏感性。结果共分离到206株肺炎链球菌，年龄分布：2岁以下儿童146株，2~5岁46株，5~14岁14株；季节分布：春季37株，夏季18株，秋季49株，冬季102株。对青霉素、克林霉素、红霉素、头孢曲松、头孢噻肟、万古霉素的敏感率分别为70.4%、3.9%、2.4%、80.1%、82.5%、100%。结论儿童肺炎链球菌感染以2岁以下婴幼儿为主，冬季最多。青霉素仍可作为治疗普通肺炎链球菌感染的首选药物；三代头孢菌素可用于青霉素非敏感的肺炎链球菌治疗；未发现万古霉素非敏感菌株；红霉素、克林霉素的耐药率极高，不适合肺链链球菌的治疗。