Oguri T
Jpn J Antibiot. 1986 Mar;39(3):783-806.
Although chemotherapeutics have markedly reduced the mortalities of infectious diseases caused by Streptococcus pneumoniae, it has recently been recognized that S. pneumoniae is still clinically significant for the infants, highly-aged and high-risk patients. This work was planned to examine the isolation frequency of S. pneumoniae from clinical specimens and its drug-susceptibilities, especially to beta-lactam antibiotics. The strains were obtained from in- and out-patients in Main and Branch Hospitals of Juntendo University from 1961 to 1985. Drug-susceptibility tests were carried out against 39 different drugs including 10 penicillins, 16 cephalosporins, 3 tetracyclines, 3 macrolides, chloramphenicol, gentamicin, vancomycin, 3 pyridone carboxylic acids and sulfamethoxazoletrimethoprim using agar dilution method. The sero-typing of the isolates was made by the Quellung technique using Diagnostic Pneumococcal Anti-Sera (Statens Seruminstitut, Copenhagen). The following results were obtained: S. pneumoniae was isolated mostly from sputum and throat swabs, but rarely from the blood and cerebrospinal fluid. S. pneumoniae was also isolated from the pus and discharges of ears, sinuses and eyes. The isolation frequency of S. pneumoniae was higher in Branch Hospital where subjects were mostly out-patients than in the Main Hospital. Frequent sero-types of S. pneumoniae were groups 23, 6, 19, and type 3, regardless of clinical specimens and years. Against tetracycline and chloramphenicol, approximately 40 to 70% of the strains were resistant, while against maclorides, resistant strains were few. Resistant strains were still fewer against beta-lactam antibiotics. Tetracycline- and chloramphenicol-resistant strains are recently decreasing, while macrolides- and beta-lactam-resistant strains are somewhat increasing. Nine beta-lactam-resistant strains of S. pneumoniae were isolated from sputum and throat swabs, with benzylpenicillin-MICs ranging from 0.39 to 3.13 micrograms/ml. Three (2 of 23F and 1 of 23A) out of the 9 strains were resistant to beta-lactams, tetracycline, chloramphenicol, erythromycin and lincomycin. Four strains (3 of 23F and 1 of group 23) were resistant to beta-lactams, tetracycline, erythromycin and lincomycin. One strain (type 45) was resistant to beta-lactams, tetracycline and chloramphenicol. One strain (23A) was resistant to beta-lactams only. Those 9 beta-lactam-resistant strains were isolated mostly from children. Most of the patients had been given beta-lactam antibiotics before those resistant strains were isolated.(ABSTRACT TRUNCATED AT 400 WORDS)
尽管化疗药物已显著降低了由肺炎链球菌引起的传染病死亡率，但最近人们认识到，肺炎链球菌对婴儿、高龄及高危患者仍具有临床重要性。本研究旨在检测肺炎链球菌从临床标本中的分离频率及其药敏情况，尤其是对β-内酰胺类抗生素的敏感性。菌株取自1961年至1985年顺天堂大学主医院和分院的门诊及住院患者。采用琼脂稀释法对39种不同药物进行药敏试验，包括10种青霉素、16种头孢菌素、3种四环素、3种大环内酯类、氯霉素、庆大霉素、万古霉素、3种吡啶酮羧酸类及磺胺甲恶唑-甲氧苄啶。采用丹麦国家血清研究所的诊断性肺炎球菌抗血清，通过荚膜肿胀技术对分离株进行血清分型。结果如下：肺炎链球菌主要从痰液和咽拭子中分离得到，但很少从血液和脑脊液中分离到。也从耳、鼻窦和眼的脓液及分泌物中分离到肺炎链球菌。在以门诊患者为主的分院，肺炎链球菌的分离频率高于主医院。无论临床标本和年份如何，肺炎链球菌常见的血清型为23、6、19群及3型。约40%至70%的菌株对四环素和氯霉素耐药，而对大环内酯类耐药的菌株较少。对β-内酰胺类抗生素耐药的菌株更少。四环素和氯霉素耐药菌株最近有所减少，而大环内酯类和β-内酰胺类耐药菌株有所增加。从痰液和咽拭子中分离出9株β-内酰胺类耐药肺炎链球菌，苄青霉素的最低抑菌浓度为0.39至3.13微克/毫升。9株中有3株（23F群2株和23A群1株）对β-内酰胺类、四环素、氯霉素、红霉素和林可霉素耐药。4株（23F群3株和23群1株）对β-内酰胺类、四环素、红霉素和林可霉素耐药。1株（45型）对β-内酰胺类、四环素和氯霉素耐药。1株（23A群）仅对β-内酰胺类耐药。这9株β-内酰胺类耐药菌株大多从儿童中分离得到。大多数患者在分离出这些耐药菌株之前已使用过β-内酰胺类抗生素。（摘要截取自400字）
