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肺炎链球菌对抗生素耐药性的研究

李洁 杨永弘 俞桑洁 袁林 胡翼云

  【摘要】 目的 研究80年代中期和90年代中期肺炎链球菌(Sp)对抗生素耐药性的变化。方法采用琼脂稀释法检测80年代中期49株和90年代中期33株Sp对12种抗生素的敏感水平。 结果Sp对青霉素的耐药率由80年代中期的6%升至90年代中期的21%,对头孢呋新、头孢噻肟和亚胺培南的耐药率由0分别升至15%、9%和12%。对红霉素的耐药率变化最明显,由2%升至79%。耐青霉素Sp可对头孢呋新、头孢噻肟、亚胺培南交叉耐药。90年代中期Sp较80年代中期耐药种类增多,在耐药模式上表现为80年代中期Sp以耐四环素和耐四环素/氯霉素为主,90年代中期的主要耐药模式除上述两种抗生素外还耐大环内酯类抗生素。结论 本组实验对象所及范围内,90年代中期Sp对青霉素、头孢呋新、头孢噻肟、亚胺培南和红霉素等抗生素的耐药性较80年代中期明显增加,提示临床应合理使用抗生素。
  【关键词】 链球菌,肺炎  抗药性,微生物  抗生素类

Antimicrobial resistance of Streptococcus pneumoniae: a comparison between the middle of 1980′s and 1990′s LI Jie, YANG Yonghong, YU Sangjie, et al. Beijing Children′s Hospital Affiliated to Capital University of Medical Sciences, Beijing 100045
  【Abstract】 Objective To study the antimicrobial resistance of Streptococcus pneumoniae (Sp) in 1983-1985 and 1995-1997.Methods The authors compared the susceptibility of Sp to antibiotics in 1983-1985 (49 isolates recovered from normally sterile body sites ) and 1995-1997 (33 isolates recovered from nasopharyngeal swabs, CSF and ear drainage of inpatients) with agar dilution.Results Penicillin-resistant Sp increased significantly from 6% in 1983-1985 to 21% in 1995-1997. The resistance of Sp to cefuroxime, cefotaxime, imipenem increased from 0 to 15%, 9% and 12%, respectively. Erythromycin-resistant Sp increased significantly from 2% to 79%. The categories of resistance increased in 1995-1997 compared to the period 1983-1985. Some penicillin-resistant Sp were resistant to cefuroxime, cefotaxime and imipenem simultaneously. The main patterns in 1983-1985 were tetracycline and tetracycline/chloramphenicol; in 1995-1997 erythromycin, clarithromycin, clindamycin were added to the main patterns.Conclusion The antimicrobial resistance of Sp to penicillin, cefuroxime, cefotaxime, imipenem, erythromycin etc. had increased in 1995 - 1997 as compared to 1983-1985 within the scope of this study. Rational use of antibiotics should be emphasize

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