摘要
目的 了解杭州地区肺炎链球菌儿童株的耐药性和流行特征。方法 用Kirby Bauer法和Etest法对 32 3株肺炎链球菌致病株和携带株进行耐药性分析 ,并对青霉素耐药株及部分相关菌株用BOX PCR技术进行遗传背景研究。结果 青霉素敏感株 136株 ,占 4 2 1% ,青霉素中介株和耐药株分别占 4 0 2 %和 17 7%。青霉素的最低抑菌浓度范围为 0 0 12～ 4 0 μg/ml。所有菌株都对头孢噻肟和万古霉素敏感。 90 7%的菌株对红霉素耐药 ,对四环素、甲氨苄啶 磺胺异噁唑的耐药率也分别高达 87 6 %和 4 8 6 % ,对氯霉素的耐药率为 14 9%。多重耐药率 6 1 0 % ,多数对红霉素、四环素和甲氨苄啶 磺胺异噁唑联合耐药。 99 4 %的菌株对利福平和氧氟沙星敏感。BOX PCR分析耐青霉素肺炎链球菌的临床株 ,未发现高度集中分布的BOX图谱 ,同一标本中分离到的表型不同的菌株或同一病人多次分离到的菌株BOX图谱可以不完全相同。结论 杭州地区肺炎链球菌耐药现象比较严重 ,头孢噻肟等第三代头孢菌素是治疗肺炎链球菌感染的理想药物。
Objective To investigate the antibiotics resistance type and molecular epidemiology of Streptococcus pneumoniae isolated from children in Hangzhou.Methods The sensitivities of 323 strains of Streptococcus pneumoniae to 9 antibiotics were determined in vitro by Kirby Bauer diffuse methods, and MICs of penicillin and cefotaxime were determined by E test methods Results Among all 323 strains isolated from children during the period from August 2001 to July 2002, 136 strains (42 1%) were sensitive to penicillin , while 57 strains (17 7%) were penicillin resistant Penicillin MICs ranged from 0 012 μg/ml to 4 0 μg/ml All the strains were sensitive to cefotaxime and its MICs ranged from 0 012 μg/ml to 4 0 μg/ml The most resistant antibiotic was erythromycin and it′s resistant rate was as high as 90 7%, followed by tetracycline (87 6%), trimethoprim sulfamethoxazole (48 6%) and chloromycetin (14 9%) Totally 197 strains (61 0%) were multi drug resistant pneumococci and most of them were resistant to trimethoprim sulfamethoxazole, erythromycin and tetracycline at the same time Two strains (0 6%) were resistant to rifampin and none was resistant to vancomycin and ofloxacin BOX PCR typing was carried out and no overwhelming fingerprinting pattern was found among penicillin resistant Streptococcus pneumoniae strains which were isolated from patients, while the banding patterns were always similar or identical among the strains isolated from the same specimen or from the same patient at different time, respectively Conclusion The antibiotics resistant rate of pneumococci was high in Hangzhou, but the third generation cephalosporins were still the best antibiotics against Streptococcus pneumoniae One child could be infected or colonized by more than one pneumococci clone at the same or different time
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2004年第1期16-19,共4页
Chinese Journal of Pediatrics
关键词
杭州地区
肺炎链球菌
耐药性
遗传学
治疗
聚合酶链反应
Streptococcus pneumoniae
Child
Drug resistance, microbial Polymerase chain yeation
