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目的分析陕西省西安地区急性呼吸道感染儿童鼻咽部肺炎链球菌 (SP)携带及耐药情况。方法采集2001年8～10月门诊就诊、年龄1个月～5岁、急性呼吸道感染、未使用或使用抗生素不超过3d共234例患儿的鼻咽部分泌物 ,分离培养SP ,并利用纸片扩散法进行抗生素敏感性检测。结果急性呼吸道感染患儿鼻咽部SP携带率为28.2 % ,年龄主要为1～4岁 ,家中居住、就诊前未使用抗生素的儿童携菌率较高。共分离出66株SP ,其中100 %对氨苄西林、阿莫西林/棒酸、头孢呋辛、头孢曲松、左氧氟沙星和万古霉素敏感 ,对阿奇霉素和克拉霉素耐药率>80% ,对复方新诺明的耐药率为54 %。结论西安地区SP在急性呼吸道感染儿童中的携带率近1/3 ,对多种抗生素有不同耐药性和敏感性 ,以对阿奇霉素、克拉霉素、复方新诺明等多重耐药为主要特点。
Objective To analyze the pathogenicity and drug resistance of nasopharyngeal pneumococci (SP) in children with acute respiratory infection in Xi’an of Shaanxi Province. Methods A total of 234 children with nasopharyngeal secretions who did not use or use antibiotics for more than 3d were enrolled in this study from August to October in 2001 with an age of 1 month to 5 years. SP was isolated and cultured. Antibiotic susceptibility testing by diffusion method. Results The incidence of nasopharyngeal SP in children with acute respiratory infection was 28.2%. The age was mainly from 1 to 4 years old. Children living in the home without antibiotics had a higher rate of carrying bacteria before treatment. A total of 66 SP isolates were isolated, of which 100% were sensitive to ampicillin, amoxicillin / clavulanic acid, cefuroxime, ceftriaxone, levofloxacin and vancomycin, resistant to azithromycin and clarithromycin> 80% The cotrimoxazole resistance rate was 54%. Conclusions SP in Xi’an is nearly one third of the children with acute respiratory tract infection, and has different resistance and sensitivity to many antibiotics. The main characteristics of SP are multi-drug resistance to azithromycin, clarithromycin and cotrimoxazole .