目的 了解近5年益陽市中心醫(yī)院臨床分離肺炎鏈球菌的血清型/群分布及耐藥趨勢，為臨床合理使用抗生素提供參考。方法 以2004—2009年期間臨床分離的822株肺炎鏈球菌為研究對象，采用莢膜腫脹試驗進(jìn)行血清分型/群，E-test檢測菌種對青霉素、頭孢呋辛、頭孢地尼、頭孢克羅、紅霉素、四環(huán)素、左氧氟沙星、萬古霉素等8種抗生素的敏感性。結(jié)果 2004年青霉素不敏感肺炎鏈球菌（PNSP）的分離率為49.4%，并呈逐年上升趨勢，至2006年P(guān)NSP分離率高達(dá)67.8%，2009年下降至51.5%。822株肺炎鏈球菌最常見的型/群是19群，其次是23、6、14、3群和其他。PNSP在6種血清型/群中所占的比例在2004—2009年期間無顯著性變化（P＞0.05）。肺炎鏈球菌對其他β內(nèi)酰胺類抗生素的非敏感趨勢類似青霉素，對紅霉素、四環(huán)素的非敏感率始終在60%以上，其中青霉素耐藥肺炎鏈球菌（PRSP）對紅霉素和四環(huán)素幾乎100%耐藥，對左氧氟沙星、萬古霉素的非敏感率均＜3%。結(jié)論 臨床分離肺炎鏈球菌以19、23、6、14、3群常見；對β內(nèi)酰胺類抗生素的非敏感率自2007年呈下降趨勢，且對左氧氟沙星、萬古霉素始終具有較高的敏感性。

Abstrct: Objective To investigate serotype/serogroup distribution and the trend of antimicrobial resistance of Streptococcus pneumoniae isolated from patients hospitalized for pneumonia in Yiyang City Central Hospital, so as to provide the guidance for rational clinical treatment. Methods Eight hundred and twenty two strains of S. pneumoniae were collected from 2004 to 2009. The isolates were serotyped/serogrouped with the quellung reaction, and minimal inhibition concentrations (MIC) of Penicillin, Cefuroxime, Cefdinir, Cefaclor, Erythromycin, Tetracycline, Levofloxacin, and Vancomycin were determined by E-test. Results The prevalence of Penicillin-nonsusceptible S. pneumoniae (PNSP) isolates increased gradually from 49.4% in 2004 to a statistical peak in 2006 (67.8%), then decreased to 51.0% in 2009. Among 822 strains of S. pneumoniae, the most prevalent serotypes/serogroups are groups 19, 23, 6, 14, 3, and others. The distribution of six serotypes in PNSP isolates was not statistically different during the years (P > 0.05). The prevalence of S. pneumoniae isolates nonsusceptible to other β-lactam antibiotics was similar to Penicillin. The prevalence of strains nonsusceptible to Erythromycin and Tetracycline was consistently > 60%. Almost all PRSP were resistant to both Erythromycin and Tetracycline throughout the period. The prevalence of strains resistant to Levofloxacin and Vancomycin were < 3% over the period. Conclusion Serotype/serogroup 19, 23, 6, 14, and 3 are the commom groups in S. pneumoniae isolated from clinic patients. Decreased prevalence of β-lactam resistant strains has been occurring since 2007, and these S. pneumoniae strains are highly sensitive to Levofloxacin and Vancomycin consistantly.