Oznur A K, Ozer Serdar, Benzonana Nur A
Dr. Lütfi Kirdar Kartal Eğitim ve Araştirma Hastanesi, infeksiyon Hastaliklari ve Klinik Mikrobiyoloji Kliniği, Istanbul.
Mikrobiyol Bul. 2006 Jul;40(3):179-84.
Antibiotic resistance in Streptococcus pneumoniae has become an important issue in the last years. Penicillin resistance rates vary among countries and among different regions in countries. It is important to know penicillin resistance rates among isolates, in planning empirical antimicrobial therapy in pneumococcal infections. In this study, the antibiotic resistance rates of S. pneumoniae strains isolated from sterile body sites were investigated with both E-test and disc diffusion methods for penicillin, erythromycin, levofloxacin, and with only disc diffusion method for chloramphenicol, ceftriaxone, vancomycin, rifampin, trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, and tetracycline. A total of 165 strains were included into the study of which 52 were isolated from blood, 46 from cerebrospinal fluids, 25 from pleural fluids, 24 from dacryocystitis materials, 13 from tympanocentesis materials, 3 from joint fluids and 2 from wound specimens. Intermediate resistance to penicilin was 18.8%, while the resistance rates to TMP-SMX, tetracycline, chloramphenicol, erythromycin and levofloxacin were detected as 21.2%, 10.9%, 9.7%, 5.4% and 0.6%, respectively. None of the isolates were highly resistant to penicillin, nor resistant to vancomycin, ceftriaxone and rifampin. In conclusion, penicillin is still the first line therapeutic agent for pneumococcal infections except for severe infections such as meningitis, in our region.
近年来,肺炎链球菌的抗生素耐药性已成为一个重要问题。各国以及一国之内不同地区的青霉素耐药率有所不同。了解分离株中的青霉素耐药率,对于规划肺炎球菌感染的经验性抗菌治疗十分重要。在本研究中,采用E试验和纸片扩散法检测了从无菌身体部位分离的肺炎链球菌菌株对青霉素、红霉素、左氧氟沙星的抗生素耐药率,采用纸片扩散法检测了对氯霉素、头孢曲松、万古霉素、利福平、复方新诺明、克林霉素和四环素的耐药率。共有165株菌株纳入本研究,其中52株从血液中分离,46株从脑脊液中分离,25株从胸腔积液中分离,24株从泪囊炎材料中分离,13株从鼓膜穿刺材料中分离,3株从关节液中分离,2株从伤口标本中分离。对青霉素的中介耐药率为18.8%,而对复方新诺明、四环素、氯霉素、红霉素和左氧氟沙星的耐药率分别检测为21.2%、10.9%、9.7%、5.4%和0.6%。分离株中无一株对青霉素高度耐药,也无一株对万古霉素、头孢曲松和利福平耐药。总之,在我们地区,除了脑膜炎等严重感染外,青霉素仍是肺炎球菌感染的一线治疗药物。