2004~2009年临床分离肺炎链球菌的血清型/群分布及耐药性监测(1)
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[摘要] 目的：了解当前本院临床分离肺炎链球菌的血清型/群分布及耐药趋势，为临床合理使用抗生素提供参考。方法：以2004~2009年临床分离的822株肺炎链球菌为研究对象，采用荚膜肿胀试验进行血清分型/群，E-test检测菌种对青霉素、头孢呋辛、头孢地尼、头孢克罗、红霉素、四环素、左氧氟沙星、万古霉素等8种抗生素的敏感性。结果：2004年青霉素不敏感肺炎链球菌(PNSP)的分离率为49.4%，并呈逐年上升趋势，至2006年PNSP分离率高达67.8%，2009年下降至51.0%。822株肺炎链球菌最常见的型/群是19群，其次是23、6、14、3、其他。PNSP在6种血清型/群中所占的比例在2004~2009年期间无显著性变化(P>0.05)。肺炎链球菌对其他β内酰胺类抗生素的非敏感趋势类似青霉素，对红霉素、四环素的非敏感率始终在60%以上，其中青霉素耐药肺炎链球菌(PRSP)对红霉素和四环素几乎100%耐药，对左氧氟沙星、万古霉素的非敏感率均<3%。结论：临床分离肺炎链球菌以19群、23群、6群、14群、3群常见；对β内酰胺类抗生素的非敏感率自2007年呈下降趋势，且对左氧氟沙星、万古霉素始终具有较高的敏感性。
[关键词] 肺炎链球菌；血清型/群；耐药性；抗生素
[中图分类号] R378.1+2[文献标识码]A [文章编号]1674-4721(2011)03(b)-009-03
Surveillance on serotype/serogroup distribution and the antimicrobial resistance of Streptococcus pneumoniae isolated from clinical patients between 2004-2009
ZHANG Xuehua
Department of Pharmacy, Central Hospital of Yiyang City in Hunan Province, Hunan Province, Yiyang413000, China
[Abstract] Objective: To investigate serotype/serogroup distribution and the trend of antimicrobial resistance of Streptococcus pneumoniae isolated from patients hospitalized for pneumonia in our hospital, so as to provide guidance for rational clical treatment. Methods: 822 strains of S.pneumoniae were collected from 2004 to 2009. Minimal inhibition concentrations(MIC) of penicillin, cefuroxime, cefdinir, cefaclor, erythromycin, tetracycline, levofloxacin, vancomycin were determined by E-test. And the isolates were serotyped with the quellung reaction. Results: The prevalence of PCG-nonsusceptible S. pneumoniae (PNSP) isolates increased gradually from 49.4% in 2004, reaching a statistical peak in 2006 (67.8%), then decreasing to 51.0% in 2009. Among 822 strains of S. pneumoniae, the most prevalent serogroups/serotypes were type 19, 23, 6, 14, 3, others. The distribution of 6 serotypes in PNSP isolates was not statistically different between years (P>0.05). The prevalence of S.pneumoniae isolates nonsusceptible to other β-lactam antibiotics, similar to penicillin ......
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