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目的:了解宁波市肺炎链球菌(SP)流行及其耐药情况,为临床合理用药提供依据。方法:采用回顾性分析方法,收集2012年1月至2015年12月宁波市妇女儿童医院住院患儿139份SP菌株,分析不同年龄、不同时间、不同季节的感染情况,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:在分离的139株SP中,2岁以下儿童最多,占66.2%,从季节来看冬季最多,占52.5%,从时间上比较,2015年分离SP菌株最多。SP对青霉素、克林霉素、红霉素、头孢曲松、头孢噻肟、万古霉素、左氧氟沙星的耐药率分别为30.9%、89.9%、92.1%、16.5%、15.1%、0.0%、5.0%。结论:宁波市儿童SP感染以2岁以下婴幼儿为主,冬季最多,SP感染有增多趋势;青霉素及第三代头孢菌素可作为治疗SP感染的首选药物;SP对红霉素、克林霉素的耐药率极高,不适合用于SP的治疗;未发现万古霉素耐药菌株。临床应依据药敏结果选择合适的抗菌药物。
Objective: To understand the prevalence and drug resistance of Streptococcus pneumoniae (SP) in Ningbo and to provide basis for clinical rational drug use. Methods: A retrospective analysis method was used to collect 139 SP strains of inpatients from January 2012 to December 2015 in Ningbo Women and Children’s Hospital. The infection status of different age, different time and different seasons were analyzed. E-test method for antimicrobial susceptibility testing, according to CLSI diagnostic criteria for susceptibility testing results. Results: Among the 139 SP isolates, the majority of children under 2 years old accounted for 66.2% of the total, and the most abundant in winter, accounting for 52.5% of the total. In terms of time, the highest number of SP isolates was obtained in 2015. The resistance rates of SP to penicillin, clindamycin, erythromycin, ceftriaxone, cefotaxime, vancomycin and levofloxacin were 30.9%, 89.9%, 92.1%, 16.5%, 15.1%, 0.0% 5.0%. Conclusion: Infection of SP in children under 2 years old is the most common in Ningbo. Most of them are in winter and the infection rate of SP is increasing. Penicillin and third generation cephalosporins are the first choice for treating SP infection. The drug resistance rate of the high-grade, not suitable for the treatment of SP; no vancomycin-resistant strains found. According to the results of drug susceptibility should choose the appropriate antimicrobial drugs.