社区呼吸道感染中肺炎链球菌对常用抗菌药物敏感性

目的了解社区获得性呼吸道感染中肺炎链球菌对常用抗菌药物的体外抗菌活性。方法先用做肺炎链球菌鉴定粗筛,后用全自动细菌分析系统的革兰阳性菌鉴定卡和单克隆乳胶试剂做肺炎链球菌的最终鉴定,药物敏感性试验用微量稀释方法测定其最低抑菌浓度。结果在1997-11~1998-04,1999-11~2000-04和2001-11~2002-04 3个阶段共收集肺炎链球菌271株。在这3个阶段,肺炎链球菌分别为83,101,87株;对青霉素不敏感率分别为9.6%,8.9%和16%,对青霉素耐药率分别为1.2%,2%和8%;对大环类脂类抗生素的敏感性分别为28.9%,39.6%和18.4%。肺炎链球菌对克拉霉素显示高水平耐药。阿其霉素和克拉霉素的交叉耐药率可达98.4%。对左氧氟沙星的耐药率分别为1.2%,6.9%和1.2%; 对复方新诺明的耐药率分别为30.1%,62.4%和66.7%;多重耐药的肺炎链球菌分别为2.4%,3.0%和6.9%。在多重耐药的肺炎链球菌中,以阿齐霉素、复方新诺明和青霉素模式为主,占72.7%(8/11),同时有80%(8/10)对青霉素耐药的肺炎链球菌发生多重耐药;肺炎链球菌对万古霉素未见有耐药株。结论对青霉素耐药的肺炎链球菌有逐年上升的趋势,定期进行细菌耐药性的监测,有助于合理应用抗菌药物。

In vitro activity of Streptococcus pneumoniae in community-acquired infection of respiratory tract to commonly used drug

Objective To investigate the resistance of Streptococcus pneumoniaeisolated in community-acquired respiratory tract infection to antimicrobial agents.Methods Streptococcus pneumoniae were first screen using Optochin disc, thenwere confirmed by gram positive identification card of vitek system and latexaggulation test, MIC of Streptococcus pneumoniae were used to detect bymicrobroth dilution method . Results A total of 271 clinical isolates of Streptococcuspneumoniae were collected from Beijing during the winter respiratory season of 1997-11~1998-04, 1999-11~2000-04 and 2001-11~2002-04 . Of these isolates, penicillinnonsusceptible was 9.6%, 8.9% and 16% , resistant was 1.2%, 2% and 8%. Susceptibleto azithromycin and clarithromycin was 28.9%, 39.6% and 18.4%. Streptococcuspneumoniae resistance to clarithromycin were high-level resistant.The crossresistance of azithromycin and clarithromycin was 98.4%. Resistance tolevofloxacinwas 1.2% , 6.9% and 1.2%. Resistance to trimethoprim-sulfamethoxazole (TMP-SMX) was 30.1%, 62.4% and 66.7%. S. pneumoniae of multiresistant was 2.4%,3.0% and 6.9%. 72.7%(8/11)of the multiresistant strains were resistant to threedifferent antimicrobial classes: penicillin, azithromycin and TMP-SMX. Eightypercent(8/10) penicillin resistant S.pneumoniae were multiresistant. Resistance to vancomycin was not detected. ConclusionResistance rates with S.pneumoniae have increased markedly during the past 6 years. Monitoring the drug resistance of bacteriaregular is helpful to application antibacterial reasonable.