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[摘要]
目的 了解近5年益阳市中心医院临床分离肺炎链球菌的血清型/群分布及耐药趋势,为临床合理使用抗生素提供参考。方法 以2004—2009年期间临床分离的822株肺炎链球菌为研究对象,采用荚膜肿胀试验进行血清分型/群,E-test检测菌种对青霉素、头孢呋辛、头孢地尼、头孢克罗、红霉素、四环素、左氧氟沙星、万古霉素等8种抗生素的敏感性。结果 2004年青霉素不敏感肺炎链球菌(PNSP)的分离率为49.4%,并呈逐年上升趋势,至2006年PNSP分离率高达67.8%,2009年下降至51.5%。822株肺炎链球菌最常见的型/群是19群,其次是23、6、14、3群和其他。PNSP在6种血清型/群中所占的比例在2004—2009年期间无显著性变化(P>0.05)。肺炎链球菌对其他β内酰胺类抗生素的非敏感趋势类似青霉素,对红霉素、四环素的非敏感率始终在60%以上,其中青霉素耐药肺炎链球菌(PRSP)对红霉素和四环素几乎100%耐药,对左氧氟沙星、万古霉素的非敏感率均<3%。结论 临床分离肺炎链球菌以19、23、6、14、3群常见;对β内酰胺类抗生素的非敏感率自2007年呈下降趋势,且对左氧氟沙星、万古霉素始终具有较高的敏感性。
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[Abstract]
Abstrct: Objective To investigate serotype/serogroup distribution and the trend of antimicrobial resistance of Streptococcus pneumoniae isolated from patients hospitalized for pneumonia in Yiyang City Central Hospital, so as to provide the guidance for rational clinical treatment. Methods Eight hundred and twenty two strains of S. pneumoniae were collected from 2004 to 2009. The isolates were serotyped/serogrouped with the quellung reaction, and minimal inhibition concentrations (MIC) of Penicillin, Cefuroxime, Cefdinir, Cefaclor, Erythromycin, Tetracycline, Levofloxacin, and Vancomycin were determined by E-test. Results The prevalence of Penicillin-nonsusceptible S. pneumoniae (PNSP) isolates increased gradually from 49.4% in 2004 to a statistical peak in 2006 (67.8%), then decreased to 51.0% in 2009. Among 822 strains of S. pneumoniae, the most prevalent serotypes/serogroups are groups 19, 23, 6, 14, 3, and others. The distribution of six serotypes in PNSP isolates was not statistically different during the years (P > 0.05). The prevalence of S. pneumoniae isolates nonsusceptible to other β-lactam antibiotics was similar to Penicillin. The prevalence of strains nonsusceptible to Erythromycin and Tetracycline was consistently > 60%. Almost all PRSP were resistant to both Erythromycin and Tetracycline throughout the period. The prevalence of strains resistant to Levofloxacin and Vancomycin were < 3% over the period. Conclusion Serotype/serogroup 19, 23, 6, 14, and 3 are the commom groups in S. pneumoniae isolated from clinic patients. Decreased prevalence of β-lactam resistant strains has been occurring since 2007, and these S. pneumoniae strains are highly sensitive to Levofloxacin and Vancomycin consistantly.
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