【摘要】 目的 :分析肺炎链球菌感染的耐药及其机制 ,以有效的指导临床进行合理的治疗与用药。方法 :对 2 0 0 3年 7月 1日至 2 0 0 3年 12月 31日就诊于儿童医院的上呼吸道感染儿童 ,进行的咽拭子培养 ,对分离出的肺炎链球菌 ,再进行耐药性方面的检测 ,用套式 PCR对 TEM基因进行检测。结果 :32例标本中对青霉素敏感的为 16 6 % ,安灭菌31% ,头孢呋肟 91% ,头孢噻肟 88% ,菌必治 94 % ,红霉素 34% ,复方新诺明 4 4 % ,氯霉素 97% ,万古霉素 10 0 % ,环丙沙星 91% ,克林霉素 2 5 % ,阿奇霉素 31% ,同时对其中 2 0例标本的 TEM基因进行检测 ,其阳性率为 5 0 %。含有 TEM基因的肺炎链球菌 ,其对β-内酰胺类药物中的青霉素耐药性较强 ,耐药率达到 90 % (9/ 10 ) ;TEM基因阴性的标本 ,其对β-内酰胺类药物的青霉素耐药性就比较弱 ,敏感率为 90 % (9/ 10 ) ,中介率 10 % (1/ 10 )更多还原

【Abstract】 Objective To guide the clinical therapy and reasonable use of antibiotic drugs, the drug resistances of Streptococcus Pneumoniae and their bla (TEM) gene were studied.Methods The drug resistance of Streptococcus Pneumoniae were determined with paper strip diffusion method (K-B method) and the TEM gene was examined using nested PCR.Results 32 strains of Streptococcus Pneumoniae were isolated from 853 patients with upper respiratory tract infection in Wuxi Child Hospital from July first, 2003 to Dec thirty-one 2003. The sensitivity rate of the isolated Streptococcus Pneumoniae to penicillin was 75 %; augmentin, 31 %; zinacef,90 %; cefetaxime, 88 %,rocephin,94 %; erythromycin, 34 %, trimoxazole,44 %; chloromycetin; 97 %; Vancomycin, 100 %; ciprofloxacin, 91 %; Clindamycin, 28 %; Azithromycin, 31 % , respectively. Among the 32 strains of Streptococcus Pneumoniae, 20 were examined for TEM gene. 10 strains had TEM gene and the positivity rate was 50 %.The penicillin tolerance rate was 90 %(9/10) in the Streptococcus Pneumoniae containing TEM gene, but the penicillin sensitivity rate was 90 %(9/10) and the intermediate rate was 10 %(1/10) in the Streptococcus Pneumoniae in which the TEM gene was not determined.更多还原