儿童肺炎链球菌感染的临床特征及药敏结果分析

摘要

Objective To investigate the clinical characteristics and drug susceptibility test results in the chil‐dren patients with Streptococcus pneumoniae infections to provide the basis for further study of colonization ,treat‐ment and prevention of clinical Streptococcus pneumoniae .Methods The retrospective analysis was carried out on the clinical and microbiological data in 172 children cases of Streptococcus pneumoniae infection in our hospital from January to December 2012 .At the same time ,the age‐ and sex‐ matched healthy children were taken as the control group .the differences of inflammatory responses were compared between the two groups .Results The specimens in 172 patients were mainly derived from sputum(96 .5% ) ,the male children patients(68 .0% ) were predominant .The median of age distribution in all the patients was 14 months(0 - 109 months) .11 kinds of commonly used antibacteri‐al drugs appeared the resistance phenomena ,in which the resistance rates of erythromycin ,clindamycin ,tetracycline , sulfamethoxazole ,etc .reached to more than 90% .But some antibacterial drugs showed higher susceptibility ,such as levofloxacin ,chloramphenicol ,vancomycin ,etc .Compared with the healthy children undergoing healthy physical ex‐amination in the same age group ,the children patients with Streptococcus pneumoniae infection presented varying de‐grees of inflammation responses .Conclusion Clinical Streptococcus pneumoniae infection is dominated by male chil‐dren under 3 years old (80 .8% ) with typical acute inflammatory responses characteristics .The clinically isolated Streptococcus pneumoniae strains are resistant against most antibacterial drugs ,and even vancomycin‐resistant strains appear .%目的：了解肺炎链球菌感染患儿的临床特征及药敏结果，为进一步研究临床肺炎链球菌的定植、治疗及预防提供依据。方法回顾性分析2012年1～12月四川大学华西第二医院172例肺炎链球菌感染的临床及微生物学资料，并以年龄、性别匹配的健康儿童作为对照组，比较2组患儿的炎性反应特征差异。结果172例患者标本主要来源于痰液（96．5％），以男性患儿为主（68．0％），中位年龄为14个月（0～109个月），11种临床常用抗生素均出现耐药现象，其中红霉素、克林霉素、四环素、复方磺胺甲噁唑等药物耐药率均高达90％以上，左氧氟沙星、氯霉素、万古霉素等敏感性较高。与同年龄组健康体检儿童相比，肺炎链球菌感染患儿均出现程度不一的炎性反应。结论肺炎链球菌感染以3岁以下男性患儿（占80．8％）为主，且急性期炎性反应特征明显，临床分离株对大多数抗生素有耐药现象，甚至已经出现耐万古霉素的菌株。