Komori T, Takabayashi T, Kuse T, Nishino K, Suzuki K, Fujita N, Yoshimura M
Clinical Laboratory Unit of University Hospital, Kyoto Prefectural University of Medicine, Japan.
Rinsho Byori. 1996 May;44(5):465-70.
Streptococcus pneumoniae is a major pathogenic organism of community-acquired bacterial pneumonia as well as otitis media and bacterial meningitis. Recently penicillin- or multiply resistant pneumococci have been isolated worldwide. In this study we examined the susceptibility tests of 11 antibiotics with the total of 63 clinically isolated pneumococci, using a broth microdilution method. Most of pneumococci were isolated from respiratory specimens. According to NCCLS standard, all these pneumococci were classified as follows: PCG-susceptible S. pneumoniae (PSSP, MIC < or = 0.06 micrograms/ml), PCG-intermediately resistant S. pneumoniae (PISP, 0.12 < or = MIC < or = 1.0 micrograms/ml), and PCG-highly resistant S. pneumoniae (PRSP, MIC > or = 2.0 micrograms/ml) were 45 (71.4%), 14 (22.2%) and 4 isolates (6.4%), respectively. Forty-four percent of isolates from children under 10 years and 29% from outpatients were PISP or PRSP. Resistance to erythromycin (EM) clindamycin (CLDM) or minocycline (MINO) was significantly recognized, but not correlated with that to PCG. On the other hand, the resistance to beta-lactam antibiotics were correlated with that to PCG. Seventeen isolates (27%) were resistant to two or more antibiotics among PCG, EM, MINO, ofloxacin (OFLX), and sulfamethoxazole-trimethoprim (ST). In pneumococcal infection, we always have to pay a careful attention to susceptibility test before we choose antibiotics.
肺炎链球菌是社区获得性细菌性肺炎、中耳炎及细菌性脑膜炎的主要致病原。近来，在全球范围内已分离出对青霉素耐药或多重耐药的肺炎球菌。在本研究中，我们采用肉汤微量稀释法，对63株临床分离的肺炎球菌进行了11种抗生素的药敏试验。大多数肺炎球菌分离自呼吸道标本。根据美国国家临床实验室标准委员会（NCCLS）标准，所有这些肺炎球菌分类如下：青霉素敏感肺炎链球菌（PSSP，MIC≤0.06μg/ml）、青霉素中介耐药肺炎链球菌（PISP，0.12≤MIC≤1.0μg/ml）和青霉素高度耐药肺炎链球菌（PRSP，MIC≥2.0μg/ml）分别为45株（71.4%）、14株（22.2%）和4株（6.4%）。10岁以下儿童分离株中44%以及门诊患者分离株中29%为PISP或PRSP。对红霉素（EM）、克林霉素（CLDM）或米诺环素（MINO）的耐药性得到显著确认，但与对青霉素的耐药性无关。另一方面，对β-内酰胺类抗生素的耐药性与对青霉素的耐药性相关。在青霉素、EM、MINO、氧氟沙星（OFLX）和磺胺甲恶唑-甲氧苄啶（ST）中，17株（27%）对两种或更多种抗生素耐药。在肺炎球菌感染中，在选择抗生素之前，我们必须始终密切关注药敏试验结果。
