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目的分析下呼吸道感染儿童肺炎链球菌(SP)对常用抗生素的药敏情况。方法采用回顾性分析方法,收集2005年1月至2009年12月温州医学院附属育英儿童医院住院患儿痰培养SP阳性且临床诊断为下呼吸道感染(包括支气管炎、毛细支气管炎、肺炎等)病例的药敏资料,分析其肺炎链球菌对常用抗生素的耐药。结果共检出643株SP,5年间SP对各种抗生素的不敏感率(中介率+耐药率)较高的前10位的药物依次为:红霉素99.3%、阿奇霉素98.6%、氯林可霉素98.3%、复方磺胺甲口恶唑95.0%、头孢克洛94.6%、头孢呋辛94.1%、四环素93.6%、青霉素93.2%、美罗培南87.4%、头孢噻肟77.9%,无耐万古霉素菌株。青霉素敏感SP组与青霉素不敏感SP组对红霉素、头孢呋辛、头孢噻肟、头孢吡肟、头孢克洛、头孢曲松、阿莫西林/棒酸、阿莫西林、美罗培南的耐药性比较均P<0.05,对氯林可霉素、氨苄青霉素、四环素、复方磺胺甲口恶唑、环丙沙星、壮观霉素、左氧氟沙星和阿奇霉素等抗菌药物均P>0.05。红霉素敏感SP组与红霉素不敏感SP组对氯林可霉素、青霉素、四环素、阿奇霉素的耐药性比较均P<0.05,对头孢菌素、复方磺胺甲口恶唑、环丙沙星、阿莫西林/棒酸、左氧氟沙星、阿莫西林、氯霉素和美罗培南等抗菌药物均P>0.05。结论温州医学院附属育英儿童医院所在地区下呼吸道感染患儿SP耐药形势严峻,不同药物呈不同程度逐年增高趋势,应引起临床足够重视。
Objective To analyze the susceptibility of commonly used antibiotics to Streptococcus pneumoniae in children with lower respiratory tract infection. Methods A retrospective analysis method was used to collect sputum culture SP positive and clinical diagnosis of lower respiratory tract infection (including bronchitis, bronchiolitis, pneumonia, etc.) from January 2005 to December 2009 in Yuyin Children’s Hospital Affiliated to Wenzhou Medical College, Case-sensitive data, analysis of Streptococcus pneumoniae commonly used antibiotic resistance. Results A total of 643 SP were detected. The top 10 drugs with high SP insensitivity to various antibiotics (mediation rate + drug resistance rate) in 5 years were as follows: erythromycin 99.3%, azithromycin 98.6%, chlorin 98.3% of the kaempferol, 95.0% of the compound sulfamethoxazole, 94.6% of cefaclor, 94.1% of cefuroxime, 93.6% of tetracycline, 93.2% of penicillin, 87.4% of meropenem and 77.9% of cefotaxime, Su strain. Penicillin-sensitive SP group and penicillin-insensitive SP group were resistant to erythromycin, cefuroxime, cefotaxime, cefepime, cefaclor, ceftriaxone, amoxicillin / clavulanic acid, amoxicillin and meropenem The antibacterials were all P <0.05. The antibacterials such as clindamycin, ampicillin, tetracycline, sulfamethoxazole, ciprofloxacin, spectinomycin, levofloxacin and azithromycin all had P> 0.05. Erythromycin sensitive SP group and erythromycin insensitivity SP group of clindamycin, penicillin, tetracycline, azithromycin resistance were P <0.05, the cephalosporin, sulfamethoxazole, cyclosporine Shaoxing, amoxicillin / clavulanic acid, levofloxacin, amoxicillin, chloramphenicol and meropenem and other antibacterials were all P> 0.05. Conclusion The situation of SP resistance in children with lower respiratory tract infection in the area where Yuyin Children’s Hospital Affiliated to Wenzhou Medical College is located is severe. Different drugs show a trend of increasing year by year, which should be paid enough attention to in clinic.