小儿下呼吸道感染肺炎链球菌耐药性分析

目的了解我院住院患儿感染肺炎链球菌的耐药性状况。方法收集儿科2010年1月至2012年1月患儿连续3次痰培养肺炎链球菌进行耐药分析。采用纸片扩散法（K—B法），药敏试验结果按NCCL200版判断标准，对照质控菌株判断敏感、中介、耐药。结果所有菌株对万古霉素敏感，耐药率为0，左氧氟沙星敏感率率较高，耐药率为3．3％，菌株对红霉素的耐药率最高，其次为克林霉素。红霉素、克林霉素耐药率为90．2％和89．3％，对复方新诺明、青霉素的敏感率有下降趋势。青霉素G耐药率为82．7％，阿莫西林克拉维酸钾、美洛西林舒巴坦的耐药率13．1％和16．4％，头孢呋辛和头孢噻肟的耐药率分别为18．9％和19．7％。结论儿科冬季下呼吸道感染。肺炎链球菌多见，以婴幼儿多见，早期用药效果欠佳，易出现并发症，并发脓胸、肺脓肿、肺炎、心肌炎，甚至并发感染性休克，应动态监测肺炎链球菌的耐药情况。指导临床合理选择抗生素，提高治愈，减少并发症。

Drug resistance analysis on streptococcus pneumoniae from lower respiratory tract infection in children patients

Objective To learn about the drug resistance condition of streptococcus pnemnoniae in children patients in our hospital. Methods We analyzed the drug resistance status of streptococcus pneumoniae isolated in children＇ s sputum for 3 consecutive times from Jan 2010 to Jan 2012.The disc diffusion method （K-B method） was used, the results of susceptibility testing was according to NCCL200 version control quality control standard of judgment, judging intermediary, resistance and sensitive. Statistical analysis used SPSS 13.0 statistical software, data of each group was compared with Chi-squared methods. Results All strains were sensitive to vancomycin, followed by levofloxacin （drug resistance rate 3.3%）, strains of erythromycin resistance rates was the highest （90.2%）, followed by clindamycin （89.3%）. Cotrimoxazole, penicillin （82.7%） sensitive rates were on a downward trend. And drug resistance rates of amoxicillin potassium clavulanate, mezlocillin sulbactam, cefuroxime and cefotaxime were 13.1%, 16.4%, 18.9% and 19.7% respectively. Conclusion For pediatric winter respiratory infections, streptococcus was very common especially in infants and young children, early drug use was ineffective and prone to complications, concurrent empyema, lung abscess, pneumonia, myocarditis, and even septic shock, it is necessary to carry out dynamic monitoring in drug resistance of streptococcus pneumoniae to guide clinical selection of antibiotics, to improve the cure rate and reduce complications.