【摘要】 目的探讨武汉市儿童医院儿童急性中耳炎肺炎链球菌分离株的临床分布特点和药敏情况。方法收集2012年1月1日-2014年12月31日急性化脓性中耳炎患儿临床资料,回顾性分析肺炎链球菌的检测结果及药敏情况。结果 146例患儿的中耳脓性分泌物共检出109株革兰阳性菌株(74.7%),其中肺炎链球菌64株,占58.7%,该菌在≤1岁、>1~3岁、>3岁的患儿中的检出数分别为31株(50.8%,31/61)、25株(56.8%,25/44)、8株(19.5%,8/41),3组比较差异有统计学意义(χ~2=14.073,P=0.001)。2012、2013、2014年青霉素耐药肺炎链球菌(PRSP)的株数分别为4株(25.0%,4/16)、2株(9.1%,2/22)、2株(7.7%,2/26),3年的PRSP分离率差异无统计学意义(χ~2=3.065,P=0.216)。分离的肺炎链球菌对红霉素、四环素、克林霉素、甲氧苄啶-磺胺甲唑、阿莫西林、头孢噻肟、头孢吡肟、氯霉素、左氧氟沙星、万古霉素的耐药率依次为:96.9%、95.3%、93.8%、84.4%、17.2%、23.4%、18.8%、4.7%、0、0。青霉素不敏感肺炎链球菌(PNSP)对头孢吡肟、阿莫西林、头孢噻肟、甲氧苄啶-磺胺甲唑的耐药率显著高于青霉素敏感肺炎链球菌(PSSP)。结论肺炎链球菌是该院<3岁急性中耳炎患儿的主要病原菌,该菌对青霉素的耐药率稳定,PRSP分离率有逐年降低的趋势。更多还原

【Abstract】 Objectives To analyze the distribution and antimicrobial susceptibility of Streptococcus pneumoniae in children with acute otitis media(AOM).Methods The clinical data of AOM children who were treated from January 1,2012 to December 31,2014 were collected and reviewed.The S.pneumoniae isolates from otorrhea samples were analyzed retrospectively in terms of antimicrobial susceptibility with SPSS 19.0.Results A total of 109(74.7%)strains of gram-positive bacteria were identified from otorrhea samples in the 146 cases of acute suppurative otitis media.S.pneumoniae was the most frequently identified bacteria(64 strains,58.7%).The number of S.pneumoniae strains was 31(50.8%)in the≤1 year infants,25(56.8%)in the infants of >1 to 3 years old,and 8(19.5%)in the children>3 years of age(χ~2=14.073,P=0.001).Of all the S.pneumoniae isolates,4(25%,4/16)strains were confirmed as penicillin-resistant S.pneumoniae(PRSP)in 2012,2(9.1%,2/22)strains in 2013,and 2(7.7%,2/26)strains in 2014(χ~2=3.065,P=0.216).The S.pneumoniae strains showed the following resistance rates in descending order:erythromycin(96.9%),tetracycline(95.3%),clindamycin(93.8%),trimethoprim-sulfamethoxazole(84.4%),amoxicillin(17.2%),cefotaxime(23.4%),cefepime(18.8%),chloramphenicol(4.7%),levofloxacin(0),and vancomycin(0),respectively.The PNSP strains had significantly higher resistance rates to cefotaxime,cefepime,amoxicillin,and trimethoprim-sulfamethoxazole than the PSSP strains.Conclusions S.pneumoniae is the main bacterial pathogen of AOM in Wuhan Children’s Hospital,especially in children less than 3 years old.The S.pneumoniae strains showed stable resistance to penicillin.The prevalence of PRSP has a decreasing trend in the 3-year period studied.更多还原