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目的了解从我国住院肺炎儿童分离的肺炎链球菌对抗菌药物的敏感性状况,为临床用药提供依据。方法肺炎链球菌分离自2006年2月～2007年2月在北京、上海、广州和深圳4家儿童医院住院的肺炎患儿,采用E试验法检测菌株对8种抗生素的敏感性。结果279株肺炎链球菌对青霉素的不敏感率为86.0%,耐药率达23.3%。在检测的β内酰胺类抗菌药物中,肺炎链球菌对阿莫西林还保持着很高的敏感率(92.1%),对头孢呋辛和头孢曲松的敏感率分别为19.0%和75.3%。几乎全部菌株(99.6%)对红霉素耐药。万古霉素和氧氟沙星的敏感率分别为99.6%和97.8%。17.6%的分离株对亚胺培南不敏感,以中介株为主。不同地区分离的肺炎链球菌对红霉素、万古霉素和氧氟沙星的敏感状况没有明显不同,但对其他几种抗菌药物的敏感性状况存在差异。结论从肺炎住院儿童分离的肺炎链球菌对阿莫西林、万古霉素和氧氟沙星敏感率高,对头孢曲松和亚胺培南比较敏感,对青霉素、头孢呋辛和红霉素普遍不敏感或耐药。
Objective To understand the sensitivity of Streptococcus pneumoniae isolates from hospitalized pneumonia in China to antimicrobial agents and to provide evidence for clinical use. Methods Streptococcus pneumoniae was isolated from children hospitalized with pneumonia in four children’s hospitals in Beijing, Shanghai, Guangzhou and Shenzhen from February 2006 to February 2007, and the susceptibility of the strains to eight antibiotics was tested by E test. Results 279 strains of Streptococcus pneumoniae insensitivity to penicillin was 86.0%, the resistance rate of 23.3%. Of the beta-lactam antibiotics tested, S. pneumoniae maintained a high sensitivity (92.1%) to amoxicillin and 19.0% and 75.3% to cefuroxime and ceftriaxone, respectively. Almost all strains (99.6%) were resistant to erythromycin. The susceptibilities of vancomycin and ofloxacin were 99.6% and 97.8%, respectively. 17.6% of the isolates were not sensitive to imipenem, mainly intermediates. The susceptibility of S. pneumoniae isolated from different regions to erythromycin, vancomycin and ofloxacin did not differ significantly, but the sensitivity to several other antibacterials varied. Conclusions Streptococcus pneumoniae isolated from hospitalized children with pneumonia has high sensitivity to amoxicillin, vancomycin and ofloxacin, and is more sensitive to ceftriaxone and imipenem, and more common to penicillin, cefuroxime and erythromycin Insensitive or resistant.