[2005年至2007年中国分离的社区呼吸道病原体的耐药性研究]
[Resistance study of community respiratory pathogens isolated in China from 2005 to 2007].
作者信息
Sun Hong-li, Yang Qi-wen, Xu Ying-chun, Wang Hui, Xie Xiu-li, Chen Min-jun, Zhang Xiu-zhen, Liu Yong, Ye Hui-fen, Sun Zi-yong, Duan Qiong, Ni Yu-xing, Yu Yun-song, Zhao Wang-sheng, He Lin, Wang Jing, Ji Ping, Liu Peng-peng, Zhang Li-xia
机构信息
Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2009 Nov 17;89(42):2983-7.
OBJECTIVE
To investigate the antimicrobial resistance of community respiratory pathogens isolated in China.
METHODS
The strains of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, S. pyogenes were isolated from patients with community-acquired respiratory tract infections at 14 Chinese hospitals from 2005 to 2007. Etest and disk diffusion methods were used to survey the susceptibility of 14 antibiotics against these strains. These antibiotics included penicillin G, ampicillin, amoxicillin/clavulanic acid, cefaclor, cefprozil, ceftriaxone, cefepime, levofloxacin, gatifloxacin, ciprofloxacin, tetracycline, clindamycin, erythromycin and trimethoprim/sulfamethoxazole (SXT).
RESULTS
A total of 1870 strains were collected including S. pneumoniae (n = 997), S. pyogenes (n = 176), H. influenzae (n = 499) and M. catarrhalis (n = 198). The 2005 - 2007 prevalence of penicillin-susceptible S. pneumoniae (PSSP) were 92.6%, 73.9%, 74.1% and penicillin-intermediate S. pneumoniae (PISP) 4.5%, 9.5%, 14.3% and penicillin-resistant S. pneumoniae (PRSP) 2.9%, 16.6%, 11.6% respectively. 36.9% of S. pneumoniae strains isolated from <or= 6 years old children were penicillin-non-susceptive isolates (PNSSP) and < 22.0% of PNSSP isolated from other age groups. The susceptible rates of beta-lactamase antibiotics to PRSP and PISP isolates were less than 25.0% and 49.2% respectively. From 48.5% to 98.6% PSSP isolates were susceptible to beta-lactamase antibiotics. The susceptible rates of PNSSP and PSSP to erythromycin, tetracycline and SXT were below 7.1% and 32.1% respectively. About 95% S. pneumoniae were susceptible to ciprofloxacin, levofloxacin and gatifloxacin. All of S. pyogenes isolates were susceptible to beta-lactamase antibiotics, and 16.7%, 27.1% and 15.6% Of S. pyogenes isolates were susceptible to erythromycin. 8.5%, 19.9%, 15.3% of H. influenzae and 57.4%, 78.8%, 95.5% of M. catarrhalis produced beta-lactamase during the 3-year period. The susceptible rates of cefepime, ceftriaxone, gatifloxacin, levofloxacin and ciprofloxacin to H. influenzae and M. catarrhalis were >or= 92.9%.
CONCLUSIONS
Antimicrobial resistance in S. pneumoniae is rising. The prevalence of PNSSP isolated from children < or = 6 years old is higher than other age groups. Amoxicillin-clavulanic acid, ceftriaxone, cefepime, gatifloxacin and levofloxacin remain highly active against common community respiratory pathogens.
目的
调查中国分离出的社区呼吸道病原体的抗菌药物耐药性。
方法
2005年至2007年从中国14家医院社区获得性呼吸道感染患者中分离出肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、化脓性链球菌菌株。采用Etest和纸片扩散法检测14种抗生素对这些菌株的敏感性。这些抗生素包括青霉素G、氨苄西林、阿莫西林/克拉维酸、头孢克洛、头孢丙烯、头孢曲松、头孢吡肟、左氧氟沙星、加替沙星、环丙沙星、四环素、克林霉素、红霉素和甲氧苄啶/磺胺甲恶唑（SXT）。
结果
共收集到1870株菌株，包括肺炎链球菌（n = 997）、化脓性链球菌（n = 176）、流感嗜血杆菌（n = 499）和卡他莫拉菌（n = 198）。2005 - 2007年青霉素敏感肺炎链球菌（PSSP）的患病率分别为92.6%、73.9%、74.1%，青霉素中介肺炎链球菌（PISP）为4.5%、9.5%、14.3%，青霉素耐药肺炎链球菌（PRSP）为2.9%、16.6%、11.6%。从≤6岁儿童分离出的肺炎链球菌菌株中36.9%为青霉素不敏感菌株（PNSSP），从其他年龄组分离出的PNSSP<22.0%。β-内酰胺酶抗生素对PRSP和PISP菌株的敏感率分别低于25.0%和49.2%。48.5%至98.6%的PSSP菌株对β-内酰胺酶抗生素敏感。PNSSP和PSSP对红霉素、四环素和SXT的敏感率分别低于7.1%和32.1%。约95%的肺炎链球菌对环丙沙星、左氧氟沙星和加替沙星敏感。所有化脓性链球菌菌株对β-内酰胺酶抗生素敏感，16.7%、27.1%和15.6%的化脓性链球菌菌株对红霉素敏感。在这3年期间，8.5%、19.9%、15.3%的流感嗜血杆菌和57.4%、78.8%、95.5%的卡他莫拉菌产生β-内酰胺酶。头孢吡肟、头孢曲松、加替沙星、左氧氟沙星和环丙沙星对流感嗜血杆菌和卡他莫拉菌的敏感率≥92.9%。
结论
肺炎链球菌的抗菌药物耐药性正在上升。从≤6岁儿童中分离出的PNSSP患病率高于其他年龄组。阿莫西林/克拉维酸、头孢曲松、头孢吡肟、加替沙星和左氧氟沙星对常见社区呼吸道病原体仍具有高活性。
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