[1]黄梅,马莉,熊安英,等.2011～2014年泸州市人民医院肺炎链球菌的耐药性分析[J].现代检验医学杂志,2015,30(06):143-146.[doi:10.3969/j.issn.1671-7414.2015.06.044]
　HUANG Mei,MA Li,XIONG An-ying,et al.Drug Resistance Analysis of Streptococcus Pneumonia in Luzhou People’s Hospital 2011～2014[J].Journal of Modern Laboratory Medicine,2015,30(06):143-146.[doi:10.3969/j.issn.1671-7414.2015.06.044]
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2011～2014年泸州市人民医院肺炎链球菌的耐药性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年06期
页码:
143-146
栏目:
检验与临床
出版日期:
2015-12-30

文章信息/Info

Title:
Drug Resistance Analysis of Streptococcus Pneumonia in Luzhou People’s Hospital 2011～2014
作者:
黄梅; 马莉; 熊安英; 周英顺; 潘庭荣
泸州市人民医院检验科，四川泸州646000
Author(s):
HUANG Mei; MA Li; XIONG An-ying; ZHOU Ying-shun; PAN Ting-rong
Department of Clinical Laboratory，Luzhou People’s Hospital，Sichuan Luzhou 646000，China
关键词:
肺炎链球菌; 耐药性; 微生物敏感性试验
分类号:
R378.12；R446.5
DOI:
10.3969/j.issn.1671-7414.2015.06.044
文献标志码:
A
摘要:
目的了解近4年泸州市人民医院肺炎链球菌的检出率和耐药情况及变化趋势。方法收集泸州市人民医院2011年1月～2014年12月分离的肺炎链球菌共306株(其中黏液型肺炎链球菌15株)，主要来源于下呼吸道标本，其次为血液。青霉素用E-test法检测其MIC，其余10种抗生素用全自动细菌鉴定和药敏分析仪的GP68卡检测其MIC。结果4年来非脑膜炎来源的青霉素不敏感的肺炎链球菌(PNSSP)占18.30%(56/306)，儿童为14.35%(30/209)，成人为26.80%(26/97)，差异具有统计学意义(χ2=6.87，P<0.01)。肺炎链球菌对多数抗生素的耐药性均有不同程度升高，尤其是红霉素、克林霉素、复方新诺明、四环素、青霉素明显。2011年红霉素的敏感性为21.43%(12/56)，2014年仅为9.18%(9/98)；2011年克林霉素的敏感性为25.0% (14/56)，2014年仅为12.24%(12/98)；2011年复方新诺明的敏感性为21.43%(12/56)，2014年仅为8.16%(8/98)；2011年四环素的敏感性为32.14%(18/56)，2014年仅为12.24%(12/98)；2011年PNSSP为10.71%(6/56)，2014年为23.47%(23/98)。莫西沙星、环丙沙星、左旋氧氟沙星仍保持良好的敏感度，敏感率分别为97.71%(299/306)，92.81%(284/306)，97.71%(299/306)。未发现耐万古霉素、利奈唑胺的菌株。黏液型肺炎链球菌占所有分离株的4.9%(15/306)，其耐药性与非黏液型有一定差异。结论2011～2014年泸州市人民医院分离的肺炎链球菌对青霉素、红霉素、克林霉素、四环素、复方新诺明的耐药性呈上升趋势，临床应结合药敏试验结果合理选择抗菌药物。
Abstract:
ObjectiveTo investigate the detection rate，the drug resistance and the change trend Streptococcus pneumoniae recent 4 years in Luzhou People’s Hospital．MethodsCollected 306 strains of Streptococcus pneumoniae isolated mainly from lower respiratory tract specimensin and secondly blood etc between January 2011 and December 2014 in Luzhou City People’s Hospital．Penicillin MIC was detected by E-test method and the other 10 kinds of antibiotics MIC were detected by automatic bacteria identification and drug sensitivity analyzer GP68 card．ResultsNon meningitis sources of penicillin resistant Streptococcus pneumoniae (PNSSP) for 4 years were accounted for 18.30% (56/306)，children 14.35% (30/209)，adult 26.80% (26/97)，and differences were Statistically significant (χ2=6.87，P<0.01)．The drug resistance of Streptococcus pneumoniae to most antibiotics had varying degrees of increase，especially erythromycin，clindamycin，compound sulfamethoxazole，tetracycline and penicillin obviously．In 2011，the sensitivity of erythromycin was 21.43% (12/56) and in 2014 only 9.18% (9/98)．In 2011，the sensitivity of clindamycin was 25% (14/56) and in 2014 only 12.24% (12/98)．In 2011，the sensitivity of cotrimoxazole was 21.43% (12/56) and in 2014 only 8.16% (8/98)．In 2011，the sensitivity of tetracycline was 32.14% (18/56) and in 2014 only 12.24% (12/98)．In 2011，PNSSP was 10.71% (6/56)，and 23.47% (23/98) in 2014．Moxifloxacin，ciprofloxacin levofloxacin were still keep the good sensitivity，and the sensitive rates were 97.71% (299/306)，92.81% (284/306) and 97.71% (299/306) respectively．No resistance to vancomycin，linezolid strains were found．Mucus type Streptococcus pneumoniae were accounted for 4.9% (15/306) of all isolates．Its resistance and non mucus had certain differences．ConclusionDrug resistance of isolated Streptococcus pneumoniae to penicillin，erythromycin，clindamycin，tetracycline，compound sulfamethoxazole had increasing trend in Luzhou City People’s Hospital between 2011 and 2014．Cinical medicine should be combined with the results of drug sensitive test for clinical selection of antibacterial drugs．

参考文献/References:

［1］付盼，何磊燕，王爱敏，等．2006～2009年复旦大学附属儿科医院呼吸道感染患儿5种常见细菌构成比和耐药性分析［J］．中国循证儿科杂志，2010，5(5)：371-376． Fu P，He LY，Wang AM，et al．Drug resistance and proportion of five common pathogens isolated from Children’s respiratory tract in Children’s Hospital of Fudan University from 2006 to 2009［J］．Chinses Journal of Evidence Based Pediatrics，2010，5(5)：371-376．
[2]李少君，吴金英，徐新波，等．肺炎链球菌大环内酯类耐药表型与相关基因的关系［J］．国际检验医学杂志，2010，31(10)：1067-1068，1071． Li SJ，Wu JY，Xu XB，et al．Macrolide resistance phenotype and resistance gene to streptococcus pneumoniae［J］．Int J Lab Med，2010，31(10)：1067-1068，1071．
[3]黄璐，李伟，丁云芳，等．儿童肺炎链球菌急性下呼吸道感染耐药监测［J］．临床儿科杂志，2010，28(6)：538-541， Huang L，Li W，Ding YF．Children with acute lower respiratory tract infection associated with drugresistant streptococcus pneumonia［J］．Journal of Clinical Pediatrics，2010，28(6)：538-541，
[4]胡付品，朱德妹，汪复，等．2011年中国CHINET细菌耐药性监测［J］．中国感染与化疗杂志，2012，12(5)：321-329． Hu FP， Zhu DM， Wang F，et al．2011 CHINFT surveillance of bacterial resistance in china［J］．Chinese Journal of Infection and Chemotherapy，2012，12(5)：321-329．
[5]王启，张菲菲，赵春江，等．2010～2011年中国肺炎链球菌耐药性和血清型研究［J］．中华结核和呼吸杂志，2013，36(2)：106-112． Wang Q，Zhang FF，Zhao CJ，et al．Antimicrobial resistance and serotype distribution of streptococcus pneumoniae isolated from multicenters across China，2010～2011［J］．Chinese Journal of Tuberculosis and Eespiratory Diseases，2013，36(2)：106-112．
[6]刘娜，王振荣，轩维清，等．唐山市儿童呼吸道肺炎链球菌的鉴定及耐药性分析［J］．现代检验医学杂志，2014，29(3)：155-157． Liu N，Wang ZR，Xuan WQ，et al．Children’s respiratory tract identification and drug resistance analysis of streptococcus pneumoniae in Tangshan［J］．J Mod Lab Med，2014，29(3)：155-157．
[7]华春珍，尚世强，李建平，等．黏液型肺炎链球菌的表型和遗传学特征［J］．中华微生物和免疫学杂志，2004，24(12)：996-999． Hua CZ，Shang SQ，Li JP，et al．Phenotype and genetic characterization of capsulated mucoid streptococcus pneumoniae isolated from children［J］．Chinese Journal of Nicrobiology and Immunology，2004，24(12)：996-999．
[8]姚开虎．肺炎链球菌性疾病及其疫苗预防［J］．中华实用儿科临床杂志，2013，28(20)：1521-1523． Yao KH．Pneumoncoccal disease and vaccine prevention［J］．Journal of Applied Clinical Pediatrics，2013，28(20)：1521-1523． 收稿日期：2015-03-02修回日期：2015-06-03(上接142页)
[8]姚海红，贾汝林，贾园，等．2011年全国多中心自身抗体检测质量控制结果分析［J］．中华风湿病学杂志，2012，16(12)：825-829． Yao HH，Jia RL，Jia Y，et al．Summary of the 2011 national autoantibody testing quality control［J］．Chinese Journal of Rheumatology，2012，16(12)：825-829．
[9]张瑞，张括，王露楠，等．2006～2011年中国临床实验室检测自身抗体的室间质量评价［J］．中华检验医学杂志，2012，35(3)：271-276． Zhang R，Zhang K，Wang LN，et al．External quality assessment of autoantibodies detection in clinical Laboratories during 2006～2011 in China［J］．Chinese Journal of Laboratory Medicine，2012，35(3)：271-276．
[10]郭大文，张英辉，单娜，等．抗核抗体核型与条带免疫抗体谱相关性分析［J］．中华实用诊断与治疗杂志，2012，26(6)：560-562． Guo DW，Zhang YH，Shan N，et al．Correlation of antinuclear antibody immunofluorescence putterns with immune profile using line immunoassay［J］．Journal of Chinese Practical Diagnosis and Therapy，2012，26(6)：560-562．
[11]黄芳，陈静宏，王香玲，等．间接免疫荧光法与蛋白印迹法检测抗核抗体的比较研究［J］．现代检验医学杂志，2013，28(4)：48-51． Huang F，Chen JH，Wang XL，et al．Comparison of indirect immunofluorescence and line immunoassay for autoantibody derection［J］．Journal of Modern Laboratory Medicine，2013，28(4)：48-51．
[12]Higashi N，Niimi Y，Aoki M，et al．Clinical features of antinuclear antibody-positive patients with atopic dermatitis［J］．J Nippon Med Sch，2009，76(6)：300-307．

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备注/Memo

备注/Memo:
作者简介：黄梅(1976-)，女，本科，副主任技师，主要从事微生物检验及耐药性检测及耐药机制研究。 通讯作者：潘庭荣，Tel：0830-2279285，E-mail：pantr577@163.com。
更新日期/Last Update: 1900-01-01