Analysis of antimicrobial resistance of Streptococcus pneumonia among 241 children with acute respiratory infections in Chongqing

Abstract:

Objective：To investigate and understand the resistance of Streptococcus pneumoniae in children with acute respiratory in－fections in Chongqing. Methods：The respiratory tract specimens（sputum，bronchoalveolar lavage fluid） from January to March，September to November in 2014 in the Children’s Hospital of Chongqing Medical University were collected，and Streptococcus pneu－monia were isolated and cultured，finally the drug sensitivity test results were achieved. Results：A total of 241 strains of Streptococcus pneumonia were isolated，erythromycin had the highest resistance rate，reaching 97.1%，followed by tetracycline 91.7%，clindamycin 89.63%. No drug-resistant strains of vancomycin was detected. Linezolid，chloramphenicol，telithromycin，levofloxacin，moxifloxacin were more sensitive，being more than 90%；Penicillin，meropenem，cefepime were not sensitive，being respectively 47.3%，81.74%，67.22%. The main patterns of resistance were meropenem+erythromycin+clindamycin+cotrimoxazole+tetracycline（21.16%）. Compared with penicillin-susceptible Streptococcus pneumoniae and penicillin-nonsusceptible Streptococcus pneumoniae，the nonsusceptible rates of erythromycin，amoxicillin，cefepime，cefotaxime，meropenem，cotrimoxazole，clindamycin had statistically significant difference（P<0.05）. Conclusion：Erythromycin，tetracycline，clindamycin should not be used in children infected with Streptococcus pneumoniae because of their higher resistance rates in Chongqing；and penicillin and cephalosporins should be carefully used in empirical treat－ment due to their high non-sensitive rates. The clinical medication should pay more attention to the bacterial culture，and rational use of antibiotics should be based on susceptibility test results，so as to prevent the spread and prevalence of drug resistant strains.