【摘要】 目的了解本地区学龄儿童鼻咽部肺炎链球菌携带情况及该菌对抗生素药物敏感性。方法选取在某院行健康体检的2~12岁儿童1 475人,采集鼻咽拭子标本后,进行肺炎链球菌分离鉴定。奥普托欣实验用于鉴定,并对阳性细菌进行抗生素耐药性检测。结果共纳入幼儿园儿童684名,小学儿童791名,幼儿园、小学儿童鼻咽部分离到肺炎链球菌85株和63株,其携带率分别为12.4%及8.0%。幼儿园儿童肺炎链球菌携带率比小学生高(χ2=8.09,P=0.004),幼儿园儿童鼻咽部携带的肺炎链球菌菌株对红霉素及四环素的耐药性均比小学儿童高,其差异有统计学意义(χ2红=3.91,P=0.048;χ2四=4.50,P=0.034);小学儿童鼻咽部携带的肺炎链球菌菌株对克林霉素及复方新诺明的耐药性高于幼儿园儿童(χ2克=5.54,P=0.019;χ2复=15.49,P<0.001)。结论柳州市健康儿童肺炎链球菌携带率较高,肺炎链球菌对红霉素、克林霉素的耐药率均在59%以上,红霉素、克林霉素已不能作为治疗肺炎链球菌的经验用药。有必要加强对健康儿童鼻携带的肺炎链球菌进行全国性的监测,为临床医生合理用药提供科学依据。更多还原

【Abstract】 Objective This work aimed to understand the Streptococcus pneumoniae nasopharyngeal carriage rate of healthy school children in local area, and the antibiotic sensitivity of S.pneumoniae. Methods The investigation was conducted in Liuzhou. 684 children aged 2~5 years from kindergarten and 891 students aged 6~12 years from elementary school were selected as subjects. The nasopharyngeal swabs were obtained and S.pneumoniae was identified with Optochin test, and antibiotic sensitivity test was performed to the isolates positive in Optochin test. Results 85(12.4%) and 63(8.0%) of S. pneumoniae were detected from kindergarten and elementary school students, respectively. S. pneumoniae carriage rate was higher among kindergarten children(χ2=8.09, P=0.004). Susceptibility test revealed that kindergarten children carried S. pneumoniae with higher erythromycin resistance(χ2=3.91, P=0.048) and tetracycline resistance(χ2=4.50, P=0.034) than elementary school children. Elementary school children carried S. pneumoniae with higher clindamycin resistance(χ2=5.54, P=0.019) and Sulfamethoxazole-trimethoprim resistance(χ2=15.49, P<0.001) than kindergarten children. Conclusion The investigation revealed that more than 59% of the S.pneumoniae isolates were resistant to erythromycin and clindamycin. These antibiotics should no longer be used for the empirical therapy for infections by S. pneumoniae. It is necessary to establish effective surveillance system to provide information for the rational use of antibiotic.更多还原