[2006 - 2008年期间在“坎塔库齐诺”国家传染病和微生物学研究所分析的耐抗生素肺炎链球菌菌株研究]

[Study of Streptococcus pneumoniae strains resistant to antibiotics analyzed at "Cantacuzino" NIRDMI during 2006-2008].

作者信息

Pană Marina, Ghiţă Maria, Nica Maria, Botea Smaranda, Dorobăţ Olga-Mihaela, Rafila Alexandru, Papagheorghe Raluca, Popescu Nicoleta, Nistor Irina, Ungureanu Vasilica

机构信息

INCDMI Cantacuzino Bucureşti.

出版信息

Bacteriol Virusol Parazitol Epidemiol. 2010 Apr-Jun;55(2):95-102.

PMID:21553474

Abstract

OBJECTIVE

The aim of the this study was the analysis of the resistance to antibiotics of Streptococcus pneumoniae isolated in last years.

METHODS

328 S. pneumoniae strains, coming from blood, CSF tracheal aspirate (TA), or sputum, pleural fluid (PL) and other samples (ear and sinus fluid) isolated in 2006-2008, were analyzed at INCDMI "Cantacuzino", National Reference Center for Streptococcus pneumoniae. Strains were tested for susceptibility to by agar diution method (minimal inhibitory concentration-MIC) to the following antibiotics: penicillin (Pc), erythromycin (Em), cephalothin (Kf). cefuroxim (Cxm), cefotaxim (Ctx), trimethoprim/sulfamethoxazol (Sxt), ofloxacin (Ojx), amoxicillin (Amx). tetracycline (Te), cloramphenicol (Cm), vancomycin (Va).

RESULTS

The analysis of the results was done according to CLSI 2009. Pneumococci strains isolated from blood, CSF, TA or sputum and PL showed lower resistance level to antibiotics (38.8% Pc, 9.3% Cxm. 4.1% Ctx, 2.7% Amx. 24% Em, 2.4% Ofx, 68% Sxt) against those isolated from ear ans sinus fluid which revealed high levels of resistance (70% Pc, 11.2 % Cxm, 5.9 % Ctx, 3.4% Amx, 58.4 % Em. 3.8% Ofx, 73% Sxt). Strains resistant to penicillin, isolated from blood and CSF revealed the following aspects: 17% low level of resistance and 11 % high level of resistance. CONCLUSIONS. The most efficient antibiotics were Ctx, Amx and Oft. A continuous surveillance of pneumococci strains resistant to antibiotics is needed, as well as the use of an pneumococcal efficient vaccine.

摘要

目的

本研究旨在分析近年来分离出的肺炎链球菌的抗生素耐药性。

方法

2006年至2008年期间从血液、脑脊液、气管吸出物（TA）、痰液、胸腔积液（PL）以及其他样本（耳液和鼻窦液）中分离出的328株肺炎链球菌菌株，在国家肺炎链球菌参考中心“坎塔库齐诺”国家传染病和微生物学研究所进行了分析。采用琼脂稀释法（最低抑菌浓度-MIC）检测菌株对以下抗生素的敏感性：青霉素（Pc）、红霉素（Em）、头孢噻吩（Kf）、头孢呋辛（Cxm）、头孢噻肟（Ctx）、甲氧苄啶/磺胺甲恶唑（Sxt）、氧氟沙星（Ojx）、阿莫西林（Amx）、四环素（Te）、氯霉素（Cm）、万古霉素（Va）。

结果

根据2009年临床和实验室标准协会（CLSI）的标准对结果进行了分析。从血液、脑脊液、TA、痰液和PL中分离出的肺炎球菌菌株对抗生素的耐药水平较低（Pc为38.8%、Cxm为9.3%、Ctx为4.1%、Amx为2.7%、Em为24%、Ofx为2.4%、Sxt为68%），而从耳液和鼻窦液中分离出的菌株耐药水平较高（Pc为70%、Cxm为11.2%、Ctx为5.9%、Amx为3.4%、Em为58.4%、Ofx为3.8%、Sxt为73%）。从血液和脑脊液中分离出的对青霉素耐药的菌株表现出以下情况：17%为低水平耐药，11%为高水平耐药。结论：最有效的抗生素是Ctx、Amx和Oft。需要持续监测对抗生素耐药的肺炎球菌菌株，并使用有效的肺炎球菌疫苗。