目的 分析陜西省楊凌示范區(qū)醫(yī)院小兒下呼吸道感染肺炎鏈球菌的耐藥性。方法 選取2008年1月-2016年1月陜西省楊凌示范區(qū)醫(yī)院下呼吸道肺炎鏈球菌感染患兒300例，對(duì)肺炎鏈球菌感染的患兒年齡分布、耐藥性及多重耐藥性進(jìn)行回顧性分析。結(jié)果 下呼吸道肺炎鏈球菌感染患兒的年齡集中于20 d～1歲，構(gòu)成比為52.0%。肺炎鏈球菌對(duì)克林霉素的耐藥率高達(dá)97.0%，其次為阿奇霉素（93.0%）、紅霉素（91.0%），對(duì)甲氧芐啶、四環(huán)素、奎奴普丁、頭孢呋辛的耐藥率均高于50.0%。肺炎鏈球菌對(duì)頭孢曲松、阿莫西林、左氧氟沙星、莫西沙星、利奈唑胺和萬古霉素的耐藥率均低于5.0%。300例下呼吸道肺炎鏈球菌中僅有21例對(duì)上述抗菌藥物均敏感，對(duì)4種及以上抗菌藥物耐藥的占57.0%?？咕幬锏氖褂迷蛑?，預(yù)防性使用例數(shù)最少，占3.00%，針對(duì)性使用和經(jīng)驗(yàn)性使用分別為173、118例，構(gòu)成比分別為57.67%、39.33%。結(jié)論 臨床醫(yī)生根據(jù)藥敏試驗(yàn)結(jié)果進(jìn)行抗菌藥物的選擇，在保證治療效果的同時(shí)避免抗生素的過度使用。

Objective To analyze the drug resistance of Streptococcus pneumoniae causing paediatric lower respiratory tract infection in Yangling Demonstration Zone Hospital in Shaanxi Province. Methods Children (300cases) infected by S. pneumoniae causing lower respiratory tract infection were selected in Yangling Demonstration Zone Hospital in Shaanxi Province from January 2008 to January 2016. Age distribution of children, drug resistance, and multiple drug resistance were analyzed retrospectively. Results Children infected by S. pneumoniae causing lower respiratory tract infection were focused on the patients who were 20 d-1 year old, and the constituent ratio was 52.0%. The resistance rate of S. pneumoniae against clindamycin was high to 97.0%, and then was azithromycin (93.0%) and erythromycin (91.0%). The resistance rates of S. pneumoniae against trimethoprim, tetracycline, quinupristin, and cefuroxime were higher than 50.0%. While the resistance rates of S. pneumoniae against ceftriaxone, amoxicillin, levofloxacin, moxifloxacin, linezolid, and vancomycin were all lower than 5.0%. In 300 cases of S. pneumoniae causing lower respiratory tract infection, only 21 cases were sensitive to the above antibacterial drugs. S. pneumoniae which was resistance to four and more antimicrobial drug accounted for 57.0%. In the reasons for the use of antibiotics, the cases of preventive use were the least (3.00%). While the cases of targeted use and empirical use was 173 and 118, respectively, with the constituent ratio of 57.67% and 39.33%. Conclusion Clinician should choose antibacterial drugs on the basis of drug sensitive test results, and guarantee the treatment effect at the same time to avoid the overuse of antibiotics.