Hussein S S, Shibl A M, Bahakem H M, Sofan M M
J Natl Med Assoc. 1989 Sep;81(9):937-41.
Streptococcus pneumoniae is the most common cause of bacterial pneumonia, otitis media, bacteremia, and meningitis in infants, children, and immunocompromised and splenectomized patients. After the introduction of penicillin in 1940, pneumococci were regarded as uniformly sensitive to minimal inhibitory concentrations (less than or equal to 0.05 microgram/mL). This idea persisted until 1967, when the first strain showing increased resistance to penicillin was isolated. Pneumococci with intermediate penicillin resistance recovered from different geographic areas have minimum inhibitory concentrations of 0.1 to 1.0 microgram/mL. In 1977, however, resistant strains were isolated with minimum inhibitory concentrations of 2 to 10 micrograms/mL; subsequently, strains resistant to other antibiotics including tetracycline, sulfonamides, erythromycin, lincomycin, chloramphenicol, clindamycin, streptomycin, and rifampin have also been reported. The authors emphasize the need for continued surveillance of pneumococcal isolates and recommend sensitivity testing of all isolates to penicillin.
肺炎链球菌是婴儿、儿童、免疫功能低下者及脾切除患者细菌性肺炎、中耳炎、菌血症和脑膜炎最常见的病因。1940年青霉素问世后，肺炎球菌被认为对最低抑菌浓度（小于或等于0.05微克/毫升）普遍敏感。这种观点一直持续到1967年，当时分离出了第一株对青霉素耐药性增强的菌株。从不同地理区域分离出的对青霉素中度耐药的肺炎球菌，其最低抑菌浓度为0.1至1.0微克/毫升。然而，1977年分离出了最低抑菌浓度为2至10微克/毫升的耐药菌株；随后，也有报道称出现了对包括四环素、磺胺类、红霉素、林可霉素、氯霉素、克林霉素、链霉素和利福平在内的其他抗生素耐药的菌株。作者强调需要持续监测肺炎球菌分离株，并建议对所有分离株进行青霉素敏感性检测。
