在侵袭性Streptococcus pneumoniae分离物中产生宏类耐药性
T B Hyde1, K Gay, D S Stephens
1National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop C-23, Atlanta, GA 30333, USA.
JAMA
|October 26, 2001
概括
肺炎链球菌的宏类抗生素耐药性正在上升,特别是在幼儿中. 大多数耐药菌株显示中度至高的最小抑制度 (MIC),这引起了对治疗有效性的担忧.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 宏类抗生素是社区获得的肺炎的主要治疗方法.
- 肺炎链球菌 (Streptococcus pneumoniae) 的宏类耐药性增加在美国引起越来越多的公共卫生关注.
- 肺炎菌株中对化物耐药性的临床意义尚不清楚.
研究的目的:
- 为了调查美国抗宏化物耐药性肺炎球菌的流行病学.
- 分析宏类抗性和相关因素的趋势.
主要方法:
- 分析了1995年至1999年间15481个侵袭性肺炎菌 Streptococcus pneumoniae分离物的分析.
- 利用疾病控制和预防中心活跃细菌核监测系统的数据.
- 检查了宏化物使用趋势,耐药性表型 (M和MLS) 和最小抑制度 (MIC).
主要成果:
- 从1993年至1999年,宏类抗生素的使用增加了13%,在5岁以下的儿童中增加了320%.
- 在Streptococcus pneumoniae中,宏类耐药性从1995年的10.6%上升到1999年的20.4%.
- 与中度MIC相关的M表型显著增加,而MLS (B) 表型保持稳定. 在幼儿和白人群体中,M型表型菌株更为普遍.
结论:
- 在美国,Streptococcus pneumoniae的宏化物耐药性很常见,与抗生素使用增加有关.
- 很大一部分耐药菌株表现出与已报告的治疗失败相关的MIC.
- 进一步的研究和监测对于了解这些发现对肺炎治疗的临床影响至关重要.
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