成都市新都地区2012年-2014年儿童感染肺炎链球菌的分布及耐药性分析

目的：了解儿童感染肺炎链球菌的分布及耐药情况，为临床合理使用抗菌药物提供依据。方法收集新都地区5家监测医院2012年1月—2014年12月自患儿血液、痰、咽拭子、耳分泌物等部位分离出的肺炎链球菌，用奥普托欣纸片和乳胶凝集试验进行鉴定，用法国生物梅里埃公司的 ATB STREP 5肺炎链球菌药敏试剂对细菌进行最低抑菌浓度（MIC）测定，补充药敏试验用琼脂纸片扩散（K-B）法进行检测。结果共分离到肺炎链球菌301株，主要来自痰236株（78.4%）、咽拭子59株（19.6%）、血液3株（1.0%）、耳分泌物3株（1.0%），301株 SP对红霉素、克林霉素、四环素、复方新诺明的耐药率较高，分别为99.00%，95.68%，90.37%，83.72%，对青霉素、阿莫西林、头孢噻肟、达福普汀/喹奴普汀、氯霉素的耐药率较低，分别为4.98%，5.31%，4.32%，2.66%，14.29%；未发现左氧氟沙星、万古霉素耐药菌株。结论新都地区红霉素、克林霉素、四环素、复方新诺明的耐药率较高，不宜用于儿童 SP 感染的治疗；青霉素和头孢类抗生素敏感率较高，可用于经验治疗。临床应根据药敏试验结果合理用药，防止耐药菌株流行传播。

Distribution of children--infected streptococcus pneumoniae and drug resistance analysis from Xindu district of Chengdu City from 2012 to 2014

Objective Understand the Xindu district of Chengdu from 2012 to 2014 children the distribution and drug resistance of streptococcus pneumoniae infection,for clinical rational use of antimicrobial agents and provide important scientific basis for prevention and treatment of disease. Methods Collect xindu district five monitoring hospital between January 2012 and December 2014 Since children blood phlegmy throat swab streptococcus pneumoniae isolated in areas such as the ear secretions,use at the xin paper and latex agglutination test for identification,Using biological merry Emmanuel France ATB STREP 5 pneumococcal susceptibility reagent for the bacteria to determine minimum bacteriostatic concentration (MIC),supplementary drug sensitive test with AGAR disc diffusion method (K-B). Results A total of isolated 301 strains streptococcus pneumoniae,mainly from sputum 236 strains (78.4%),pharyngeal swab 59 strains (19.6%),Blood 3 strains (1.0%),Ear Discharge3 strains (1.0%),301 strains of SP of erythromycin clindamycin, tetracycline compound new,higher percentages of Ming.99.00% 95.68% 90.37% ,83.72 respectively.To penicillin, amoxicillin,cefotaxime,dafoe slave ketoneses leptin/leptin and chloramphenicol resistance is low,Respectively 4.98% , 5.31% ,4.32% ,2.66% ,4.32% ;Not found levofloxacin,vancomycin resistant strains. Conclusion Xindu district of erythromycin,clindamycin,tetracycline,compound new bright,high percentages,Should not be used for treatment of SP infections in children;Penicillin and cephalosporin antibiotics sensitive rate is higher,the experience can be used for treatment. Clinical should according to the results of drug sensitive test the rational use of drugs,prevent the spread of drug-resistant strains pop.