大理大学学报 ›› 2021, Vol. 6 ›› Issue (2): 90-94.DOI: 10. 3969 / j. issn. 2096-2266. 2021. 02. 020

• 临床医学 • 上一篇    下一篇

2017—2019年大理市某医院肺炎链球菌感染分布及耐药性分析

程明璟1,李福兴1,忽胜和2*   

  1. (1.大理大学临床医学院,云南大理671000;2.大理大学第一附属医院检验科,云南大理671000)
  • 收稿日期:2020-06-10 修回日期:2020-07-15 出版日期:2021-02-15 发布日期:2021-03-17
  • 通讯作者: 忽胜和,主任检验师,E-mail:dlhushenghe@126.com。
  • 作者简介:程明璟,检验技师,主要从事临床微生物学检验研究。

(责任编辑李杨)#br# Distribution and Drug Resistance of Streptococcus pneumoniae Infection#br# in a Hospital in Dali City from 2017 to 2019

Cheng Mingjing1, Li Fuxing1, Hu Shenghe2*   

  1. (1. Clinical College, Dali University, Dali, Yunnan 671000, China; 2. Laboratory Department, The First Affiliated Hospital of
    Dali University, Dali, Yunnan 671000, China)
  • Received:2020-06-10 Revised:2020-07-15 Online:2021-02-15 Published:2021-03-17

摘要: 目的:分析大理大学第一附属医院肺炎链球菌感染分布特点、耐药性及其变化趋势。方法:对大理大学第一附属医院
2017年1月至2019年12月住院患者的痰液、肺泡灌洗液、血液、分泌物、脑脊液、脓液、胆汁标本进行分离培养和细菌鉴定、药
敏试验和结果判定,对数据进行统计分析。结果:共分离333株肺炎链球菌,标本主要来源于痰液(占90.99%),科室主要来源
于儿科(占53.75%);年龄≤1岁的患儿占36.64%,1~18岁(含18岁)患者占19.22%,18~60岁(含60岁)患者占19.52%,>60岁患
者占24.62%。肺炎链球菌占所有分离细菌的2.31%,按季度统计其占细菌的分离比,第一季度(3.09%)>第四季度(2.57%)>第
二季度(2.09%)>第三季度(1.77%),但各季度之间肺炎链球菌分离比差异不大。肺炎链球菌对四环素、红霉素和复方磺胺甲
噁唑的耐药率高(70.40%~93.65%),对氯霉素、头孢曲松、美罗培南、阿莫西林、头孢噻肟、左氧氟沙星、泰利霉素、氧氟沙星、莫
西沙星的耐药率较低(0.00%~27.20%),未发现对万古霉素、厄他培南和利奈唑胺耐药的肺炎链球菌。结论:肺炎链球菌主要
分离于痰液标本,感染病例主要分布于儿科,年龄≤1岁的患儿是感染主体。肺炎链球菌的分离比各季度之间差异不大。青霉
素和阿莫西林、第三代头孢菌素可作为治疗大理大学第一附属医院肺炎链球菌感染的一线药物。

关键词: 肺炎链球菌, 临床分布, 耐药性

Abstract: Objective: To analyze the distribution of Streptococcus pneumoniae infection, drug resistance and its changing trend in the
First Affiliated Hospital of Dali University. Methods: Sputum, alveolar lavage fluid, blood, secretions, cerebrospinal fluid, pus and bile
specimens of hospitalized patients from January 2017 to December 2019 in the First Affiliated Hospital of Dali University were isolated
and cultured, and the bacteria were identified, the drug sensitivity tested, the results determined, and the data were statistically
analyzed. Results: A total of 333 strains of Streptococcus pneumoniae were isolated, with the specimens mainly from sputum(90.99%)
of the patients in pediatrics department(53.75%). Infants aged ≤1 year accounted for 36.64% of the total number, patients aged 1 to 18
years(including 18 years old)accounted for 19.22%, patients aged 18 to 60 years(including 60 years old)accounted for 19.52%, and
patients aged over 60 years accounted for 24.62%. Streptococcus pneumoniae accounted for 2.31% of all isolated bacteria, and its
proportion in bacterial isolation was calculated quarterly: the proportion in the first quarter(3.09%)> that in the fourth quarter(2.57%)
> that in the second quarter(2.09%)> that in the third quarter(1.77%), but there was little difference in Streptococcus pneumoniae
separation rate between quarters. Streptococcus pneumoniae has high resistance rates to tetracycline, erythromycin and compound
sulfamethoxazole(70.40%-93.65%), has low resistance rates to chloramphenicol, ceftriaxone, meropenem, amoxicillin, cefotaxime,
levofloxacin, telithromycin, ofloxacin, moxifloxacin(0.00%-27.20%), and no Streptococcus pneumoniae resistant to vancomycin,
ertapenem and linezolid was found. Conclusion: Streptococcus pneumoniae was mainly isolated from sputum specimens, and the infection
cases were mainly distributed in pediatrics. Children≤1 year were the main body of infection. The separation rate of Streptococcus
pneumoniae was not significantly different among quarters. Penicillin, amoxicillin and third generation cephalosporin can be used as
first-line drugs in the treatment of pneumococcal infection in the First Affiliated Hospital of Dali University.

Key words: Streptococcus pneumoniae, clinical distribution, antibiotic resistance

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