Backhaus Erik, Berg Stefan, Trollfors Birger, Andersson Rune, Persson Elisabet, Claesson Berndt E B, Larsson Peter, Ek Elisabeth, Jonsson Lars, Rådberg Gunilla, Johansson Siv, Ripa Torvald, Karlsson Diana, Andersson Kerstin
Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden.
Scand J Infect Dis. 2007;39(1):19-27. doi: 10.1080/00365540600895043.
Invasive disease caused by antibiotic resistant pneumococci is a worldwide problem. All invasive pneumococcal strains in an area of south-west Sweden with 1.7 million inhabitants were collected prospectively during 1998-2001. Minimum inhibitory concentrations (MICs) were determined by E-test and correlated to serotypes and clinical characteristics. Of 827 strains, 744 (90%) were susceptible (S) to all agents tested and 83 (10%) were indeterminate (I) or resistant (R) to at least 1 agent. 22 isolates (2.7%) were I to penicillin (MIC >0.06 to < or = 1.0 mg/l), but none were R (MIC >1.0 mg/l). Numbers and proportions of decreased susceptibility against other agents tested were as follows: erythromycin R: 30 (3.6%), clindamycin R: 6 (0.7%), tetracycline R: 16 (1.9%), moxifloxacin R: 1 (0.1%), cotrimoxazole I: 17 (2%) and R: 31(4%). Non-susceptibility to at least 1 agent was not correlated with age, clinical manifestation, underlying diseases and outcome. The serotype distribution differed between non-susceptible and susceptible strains. The serotypes in the 7-valent pneumococcal conjugate vaccine covered 42% of all infections and 73% of those caused by non-susceptible strains. In conclusion, the impact of antibiotic resistance in invasive pneumococcal disease remains limited in south-west Sweden.
由耐抗生素肺炎球菌引起的侵袭性疾病是一个全球性问题。1998年至2001年期间，前瞻性收集了瑞典西南部一个有170万居民地区的所有侵袭性肺炎球菌菌株。通过E试验测定最低抑菌浓度（MICs），并将其与血清型和临床特征相关联。在827株菌株中，744株（90%）对所有测试药物敏感（S），83株（10%）对至少1种药物不确定（I）或耐药（R）。22株分离株（2.7%）对青霉素呈I类（MIC>0.06至≤1.0mg/l），但无R类（MIC>1.0mg/l）。对其他测试药物敏感性降低的数量和比例如下：红霉素R：30株（3.6%），克林霉素R：6株（0.7%），四环素R：16株（1.9%），莫西沙星R：1株（0.1%），复方新诺明I：17株（2%）和R：31株（4%）。对至少1种药物不敏感与年龄、临床表现、基础疾病和转归无关。非敏感株和敏感株的血清型分布不同。7价肺炎球菌结合疫苗中的血清型覆盖了所有感染的42%和非敏感株引起感染的73%。总之，在瑞典西南部，侵袭性肺炎球菌疾病中抗生素耐药性的影响仍然有限。
