河南省220所医院肺炎链球菌分布及药物敏感性监测
Distribution and Drug Susceptibility Monitoring of Streptococcus pneumoniae in 220 Hospitals in Henan Province
李宁 1张琦 2刘欢 1常军玲 1王保亚 2袁有华 2李轶 2曹兴华1
作者信息
- 1. 漯河市中心医院,河南漯河 462000
- 2. 河南省人民医院,郑州 450003
- 折叠
摘要
目的 了解河南省141家二级医院和79家三级医院临床分离的肺炎链球菌分布特点及耐药情况,为各级医院临床抗感染治疗提供依据.方法 收集2019年—2021年临床分离非重复肺炎链球菌菌株,采用自动化仪器和E试验条法进行药物敏感性试验,按美国临床和实验室标准化协会(CLSI)2022年版标准判读结果.采用Whonet 5.6及Spss 26.0软件进行数据统计分析.结果 共分离肺炎链球菌15 480株,主要来自痰液(78.1％)、血液(6.7％),患者集中在儿科(40.5％),冬季占比最高(46.1％).未检出耐万古霉素和利奈唑胺的肺炎链球菌;随年龄增长氯霉素敏感率呈下降趋势,脑脊液菌株中PSSP检出率32％,非脑脊液菌株PSSP检出率＞92％,二级医院菌株敏感率普遍低于三级医院,差异有统计学意义(P＜0.001).结论 肺炎链球菌多检自冬季儿科患者的痰液标本.青霉素和头孢曲松仍可作省内儿童抗感染治疗的首选,成人还可备选左氧氟沙星.青霉素不再适合脑膜炎的抗感染治疗.各级医院应提升检测能力,以期获得准确药敏结果.
Abstract
Objective In Henan province,Streptococcus pneumoniae isolates from 141 secondary hospitals and 79 tertiary hospitals were studied to better understand their medication resistance and distribution patterns.This information will serve as a foundation for clinical anti-infection treatment in hospitals across the board.Methods Collect non-repetitive Streptococcus pneumoniae strains clinically isolated from 2019 to 2021,conduct drug sensitivity tests using automated instruments and the E-test strip method,and interpret the results according to the American Clinical and Laboratory Standardization Institute(CLSI)2022 standard.Data statistical analysis was conducted using Whonet 5.6 and Spss 26.0 software.Results A total of 15 480 strains of Streptococcus pneumoniae were isolated,mainly from sputum(78.1％)and blood(6.7％).Pediatric patients made up the majority of the patient population(40.5％),with winter accounting for the largest percentage(46.1％);no evidence of vancomycin or linezolid-resistant Streptococcus pneumoniae was found;the sensitivity rate to chloramphenicol falls with age,with 32％of strains in cerebrospinal fluid being detected for PSSP and 92％of strains in non-cerebrospinal fluid.The sensitivity rate of strains in secondary hospitals is generally lower than that in tertiary hospitals,and the difference is statistically significant(P＜0.001).Conclusion Streptococcus pneumoniae is mostly detected in sputum samples of pediatric patients in winter.Penicillin and ceftriaxone can still be the first choice for anti-infection treatment in children within the province,and levofloxacin can also be used as an alternative for adults.Penicillin is no longer suitable for anti-infective treatment of meningitis.Hospitals at all levels should enhance their testing capabilities in order to obtain accurate drug sensitivity results.
关键词
肺炎链球菌/儿童/耐药性分析/抗菌药物/不同级别医院药敏Key words
Streptococcus pneumoniae/children/drug resistance analysis/antibacterial drugs/drug sensitivity in hospitals of different levels引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20200016)
河南省科技攻关项目(202102310355)
出版年
2024
NETL
NSTL
万方数据