Reichler M R, Rakovsky J, Sobotová A, Sláciková M, Hlavácová B, Hill B, Krajcíková L, Tarina P, Facklam R R, Breiman R F
Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 1995 Jun;171(6):1491-6. doi: 10.1093/infdis/171.6.1491.
Penicillin-resistant pneumococci have been isolated from middle ear fluid, blood, cerebrospinal fluid, and nasopharyngeal secretions of several hundred children in Slovakia since 1985; 116 of these isolates were serotyped and tested for susceptibility to antimicrobial drugs at the Centers for Disease Control and Prevention. To define the prevalence of drug-resistant pneumococci and identify risk factors for infection, laboratory and medical records were reviewed. Nearly all (96%) of the resistant strains tested were serotype 14. Of these, all were resistant to penicillin (MIC, 4-16 micrograms/mL); most were resistant to cefaclor, erythromycin, tetracycline, and chloramphenicol; and many had decreased susceptibility to trimethoprim-sulfamethoxazole and ceftriaxone. Frequent antibiotic use, prior hospitalization, and length of hospital stay (P < .001 for all 3) were associated with infection with resistant strains. These findings suggest the need for routine screening of pneumococcal isolates for penicillin resistance and highlight the importance of controlling globally the spread of resistant pneumococci.
自1985年以来，在斯洛伐克数百名儿童的中耳液、血液、脑脊液和鼻咽分泌物中分离出了耐青霉素肺炎球菌；其中116株分离菌在疾病控制和预防中心进行了血清分型及抗菌药物敏感性检测。为了确定耐药肺炎球菌的流行情况并识别感染的危险因素，对实验室和医疗记录进行了审查。几乎所有（96%）检测的耐药菌株都是14型。其中，所有菌株都对青霉素耐药（最低抑菌浓度，4 - 16微克/毫升）；大多数对头孢克洛、红霉素、四环素和氯霉素耐药；许多菌株对甲氧苄啶 - 磺胺甲恶唑和头孢曲松的敏感性降低。频繁使用抗生素、既往住院史和住院时间（所有3项P <.001）与耐药菌株感染有关。这些发现表明需要对肺炎球菌分离株进行常规青霉素耐药性筛查，并强调全球控制耐药肺炎球菌传播的重要性。
