Appelbaum P C
Department of Pathology, Hershey Medical Center, Pennsylvania 17033.
Clin Infect Dis. 1992 Jul;15(1):77-83. doi: 10.1093/clinids/15.1.77.
Clinical resistance to penicillin in Streptococcus pneumoniae was first reported by researchers in Boston in 1965; subsequently, this phenomenon was reported from Australia (1967) and South Africa (1977). Since these early reports, penicillin resistance has been encountered with increasing frequency in strains of S. pneumoniae from around the world. In South Africa strains resistant to penicillin and chloramphenicol as well as multiresistant strains have been isolated. Similar patterns of resistance have been reported from Spain. Preliminary evidence points to a high prevalence of resistant pneumococci in Hungary, other countries of Eastern Europe, and some countries in other areas of Europe, notably France. In the United States most reports of resistant pneumococci come from Alaska and the South, but resistance is increasing in other states and in Canada. Pneumococcal resistance has also been described in Zambia, Japan, Malaysia, Pakistan, Bangladesh, Chile, and Brazil; information from other African, Asian, and South American countries is not available. The rising prevalence of penicillin-resistant pneumococci worldwide mandates selective susceptibility testing and epidemiological investigations during outbreaks.
1965年，波士顿的研究人员首次报告了肺炎链球菌对青霉素的临床耐药性；随后，澳大利亚（1967年）和南非（1977年）也报告了这一现象。自这些早期报告以来，世界各地肺炎链球菌菌株中青霉素耐药性的出现频率不断增加。在南非，已分离出对青霉素和氯霉素耐药的菌株以及多重耐药菌株。西班牙也报告了类似的耐药模式。初步证据表明，匈牙利、东欧其他国家以及欧洲其他地区的一些国家（尤其是法国）耐药肺炎球菌的患病率很高。在美国，大多数耐药肺炎球菌的报告来自阿拉斯加和南部地区，但其他州和加拿大的耐药性也在增加。赞比亚、日本、马来西亚、巴基斯坦、孟加拉国、智利和巴西也描述了肺炎球菌耐药性；尚无来自其他非洲、亚洲和南美国家的信息。全球范围内青霉素耐药肺炎球菌患病率的上升要求在疫情期间进行选择性药敏试验和流行病学调查。
