目的 分析陕西省杨凌示范区医院小儿下呼吸道感染肺炎链球菌的耐药性。方法 选取2008年1月-2016年1月陕西省杨凌示范区医院下呼吸道肺炎链球菌感染患儿300例，对肺炎链球菌感染的患儿年龄分布、耐药性及多重耐药性进行回顾性分析。结果 下呼吸道肺炎链球菌感染患儿的年龄集中于20 d～1岁，构成比为52.0%。肺炎链球菌对克林霉素的耐药率高达97.0%，其次为阿奇霉素（93.0%）、红霉素（91.0%），对甲氧苄啶、四环素、奎奴普丁、头孢呋辛的耐药率均高于50.0%。肺炎链球菌对头孢曲松、阿莫西林、左氧氟沙星、莫西沙星、利奈唑胺和万古霉素的耐药率均低于5.0%。300例下呼吸道肺炎链球菌中仅有21例对上述抗菌药物均敏感，对4种及以上抗菌药物耐药的占57.0%。抗菌药物的使用原因中，预防性使用例数最少，占3.00%，针对性使用和经验性使用分别为173、118例，构成比分别为57.67%、39.33%。结论 临床医生根据药敏试验结果进行抗菌药物的选择，在保证治疗效果的同时避免抗生素的过度使用。

Objective To analyze the drug resistance of Streptococcus pneumoniae causing paediatric lower respiratory tract infection in Yangling Demonstration Zone Hospital in Shaanxi Province. Methods Children (300cases) infected by S. pneumoniae causing lower respiratory tract infection were selected in Yangling Demonstration Zone Hospital in Shaanxi Province from January 2008 to January 2016. Age distribution of children, drug resistance, and multiple drug resistance were analyzed retrospectively. Results Children infected by S. pneumoniae causing lower respiratory tract infection were focused on the patients who were 20 d-1 year old, and the constituent ratio was 52.0%. The resistance rate of S. pneumoniae against clindamycin was high to 97.0%, and then was azithromycin (93.0%) and erythromycin (91.0%). The resistance rates of S. pneumoniae against trimethoprim, tetracycline, quinupristin, and cefuroxime were higher than 50.0%. While the resistance rates of S. pneumoniae against ceftriaxone, amoxicillin, levofloxacin, moxifloxacin, linezolid, and vancomycin were all lower than 5.0%. In 300 cases of S. pneumoniae causing lower respiratory tract infection, only 21 cases were sensitive to the above antibacterial drugs. S. pneumoniae which was resistance to four and more antimicrobial drug accounted for 57.0%. In the reasons for the use of antibiotics, the cases of preventive use were the least (3.00%). While the cases of targeted use and empirical use was 173 and 118, respectively, with the constituent ratio of 57.67% and 39.33%. Conclusion Clinician should choose antibacterial drugs on the basis of drug sensitive test results, and guarantee the treatment effect at the same time to avoid the overuse of antibiotics.