临床儿科杂志
臨床兒科雜誌
림상인과잡지
2013年
8期
715-718
,共4页
向贇%王瑞耕%张振%刘新文%许敬
嚮贇%王瑞耕%張振%劉新文%許敬
향빈%왕서경%장진%류신문%허경
肺炎链球菌%下呼吸道感染%耐药率%儿童
肺炎鏈毬菌%下呼吸道感染%耐藥率%兒童
폐염련구균%하호흡도감염%내약솔%인동
Streptococcus pneumoniae%lower respiratory tract infection%antibiotic resistance rate%child
目的分析下呼吸道感染患儿肺炎链球菌（SP）分离株的临床特征及其对常用抗生素的药敏情况，为临床合理用药提供依据。方法采用回顾性分析法，收集2008年1月到2012年12月自下呼吸道感染患儿分离的SP 6358株，采用纸片扩散法及E-test法进行抗菌药物敏感试验；按CLSI判断标准分析药敏结果。结果 SP分离株主要来自于儿内科各专业科室，感染病例以各类肺炎和支气管炎为主。在分离的6358株SP中，青霉素、头孢噻肟、红霉素、克林霉素、复方新诺明、四环素、氯霉素、左氧氟沙星、万古霉素的耐药率分别为5.0%、12.9%、98.7%、96.0%、92.2%、7.3%、5.6%、0.2%、0.0%；青霉素与头孢噻肟的年耐药率差异均有统计学意义（P均<0.05）。318株耐青霉素SP对上述药物的耐药率分别为100.0%、42.6%、100.0%、100.0%、99.2%、23.6%、6.8%、0.6%、0.0%，青霉素与头孢噻肟间比较，耐药率差异有统计学意义（P=0.001）。结论下呼吸道感染患儿分离的SP对红霉素、克林霉素、复方新诺明及四环素的耐药率较高，对头孢噻肟的耐药率呈逐年递增的趋势，临床应依据药敏结果选择合适的抗菌药物。
目的分析下呼吸道感染患兒肺炎鏈毬菌（SP）分離株的臨床特徵及其對常用抗生素的藥敏情況，為臨床閤理用藥提供依據。方法採用迴顧性分析法，收集2008年1月到2012年12月自下呼吸道感染患兒分離的SP 6358株，採用紙片擴散法及E-test法進行抗菌藥物敏感試驗；按CLSI判斷標準分析藥敏結果。結果 SP分離株主要來自于兒內科各專業科室，感染病例以各類肺炎和支氣管炎為主。在分離的6358株SP中，青黴素、頭孢噻肟、紅黴素、剋林黴素、複方新諾明、四環素、氯黴素、左氧氟沙星、萬古黴素的耐藥率分彆為5.0%、12.9%、98.7%、96.0%、92.2%、7.3%、5.6%、0.2%、0.0%；青黴素與頭孢噻肟的年耐藥率差異均有統計學意義（P均<0.05）。318株耐青黴素SP對上述藥物的耐藥率分彆為100.0%、42.6%、100.0%、100.0%、99.2%、23.6%、6.8%、0.6%、0.0%，青黴素與頭孢噻肟間比較，耐藥率差異有統計學意義（P=0.001）。結論下呼吸道感染患兒分離的SP對紅黴素、剋林黴素、複方新諾明及四環素的耐藥率較高，對頭孢噻肟的耐藥率呈逐年遞增的趨勢，臨床應依據藥敏結果選擇閤適的抗菌藥物。
목적분석하호흡도감염환인폐염련구균（SP）분리주적림상특정급기대상용항생소적약민정황，위림상합리용약제공의거。방법채용회고성분석법，수집2008년1월도2012년12월자하호흡도감염환인분리적SP 6358주，채용지편확산법급E-test법진행항균약물민감시험；안CLSI판단표준분석약민결과。결과 SP분리주주요래자우인내과각전업과실，감염병례이각류폐염화지기관염위주。재분리적6358주SP중，청매소、두포새우、홍매소、극림매소、복방신낙명、사배소、록매소、좌양불사성、만고매소적내약솔분별위5.0%、12.9%、98.7%、96.0%、92.2%、7.3%、5.6%、0.2%、0.0%；청매소여두포새우적년내약솔차이균유통계학의의（P균<0.05）。318주내청매소SP대상술약물적내약솔분별위100.0%、42.6%、100.0%、100.0%、99.2%、23.6%、6.8%、0.6%、0.0%，청매소여두포새우간비교，내약솔차이유통계학의의（P=0.001）。결론하호흡도감염환인분리적SP대홍매소、극림매소、복방신낙명급사배소적내약솔교고，대두포새우적내약솔정축년체증적추세，림상응의거약민결과선택합괄적항균약물。
Objective To explore clinical features and drug sensitivity of Streptococcus pneumoniae (SP) isolated from pediatric patients with lower respiratory tract infection, and to provide evidence for clinical use of antibiotics. Methods A total of 6 358 clinical SP isolates from children with lower respiratory tract infection from January 2008 to December 2012 were col-lected and retrospectively analyzed. The antibiotic sensitivity was done by Kirby-Bauer method and E-test, and all results were in strict accordance with the rules of CLSI. Results The isolated SP strains were mainly from different departments of pediatrics. All clinical cases with SP infection mainly included pneumonia and bronchitis. The resistance rates of 6 358 SP strains to penicil-lin, cefotaxime, erythromycin, clindamycin, cotrimoxazole, tetracycline, chloramphenicol, levolfoxacin, vancomycin were 5.0%, 12.9%, 98.7%, 96.0%, 92.2%, 7.3%, 5.6%, 0.2%and 0.0%respectively, and the resistance rate to penicillin and cefotaxime was signiifcantly different in every years (all P<0.05). The resistance rates of the 318 penicillin-resistant SP strains to the above anti-biotics were 100.0%, 42.6%, 100.0%, 100.0%, 99.2%, 23.6%, 6.8%, 0.6%, 0.0%respectively, and the resistance rate to penicillin and cefotaxime was signiifcantly different (P=0.001). Conclusions The antibiotic resistance rates of SP strains isolated from children with lower respiratory tract infection were higher to erythromycin, clindamycin, cotrimoxazole and tetracycline, and an increasing rate in drug resistance to cefotaxime was observed in recent years. Appropriate antibiotics should be selected for the treatment of infection according to drug sensitivity.
