儿童肺炎链球菌抗生素敏感性监测

目的 :了解广州地区儿童肺炎链球菌对常用抗生素的敏感性 ,以有效指导临床合理用药。方法 :连续两年对广州市儿童医院就诊的上呼吸道感染患儿的鼻咽分泌物进行细菌培养 ,分离出肺炎链球菌157株 ,采用纸片法及E -Test法对分离株进行常用抗生素敏感性检测。结果 :肺炎链球菌对青霉素不敏感率为53 5 % ,不敏感株对 β-内酰胺类、红霉素、复方磺胺甲基异唑的耐药率明显高于青霉素敏感株 ,且多重耐药率高达90 %以上 ;肺炎链球菌对阿莫西林/克拉维酸、头孢曲松有很好的敏感性 ,而对头孢呋辛敏感性仅为59 % ;其中2001年分离株对头孢克洛耐药率为56 % ,对红霉素耐药率高达78 % ,对四环素耐药率为87 9 % ,对复方磺胺甲基异唑的耐药很突出 (69 % ) ,而对氯霉素仍保持低水平耐药 (33 3 % )。结论 :广州地区儿童肺炎链球菌耐药形势严峻 ,不敏感率已达中等水平 ,且有逐年上升的趋势 ,尤以红霉素、四环素、复方磺胺甲基异唑等多重耐药为主要特点。

Survey of Antimicrobial Susceptibility of S.Pneumonia in Children

OBJECTIVE:To investigate the situation of antibiotic resistance of S.pneumoniae(Sp)of clinical isolates from children in Guangzhou.METHODS:The authors cultured,isolated and identified the Sp strains from nasopharyngeal secretion of patients who visited Guangzhou children's hospitals because of upper respiratory tract infections in2000and2001.The paper strip method and E-Test of antibiotic susceptibility were done for157isolates.RESULTS:The penicillin resistant Sp(PRSP)isolates accounted for53.5%.PRSP isolates showed a higher resistance to otherβ-lactam antimcrobal,erythromycin and trimethoprim/sulfamethoxazole as compared to penicillin susceptible Sp(PSSP)isolates.More than90%of PRSP were mulˉtidrug resistant strains.The strains of Sp were susceptible to amoxicillin/clavulamic acid and ceftriaxone.Strains had decreaced susceptibility(59%)to cefuroxime.In2001,the rate of cefaclor resistance was56%.The prevalence of erythromycin resistant Sp in this study was up to78%.The rate of tetra-cycline resistance were87.9%.Trimethoprim/sulphamethoxazole(TMP/SMX)resistant rate was as high as69%.The chloramphenicol resistant isolats were in stable low levels(33.3%).CONCLUSI_ ON:The resistant Sp isolated from children with respiratory tract infections in this area would be a severe problem.PRSP rate was increased and was characterized by a multi-resistance to erythromycin,tetracycline and TMP/SMX.