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Abstract：
OBJECTIVE: To determine the prevalence of antimicrobial resistance in clinical isolates of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis from medical centres across Canada.
METHODS: Fifty laboratories from across Canada were asked to collect up to 25 consecutive clinical isolates of S pneumoniae, H influenzae and M catarrhalis at some time between September 1994 and May 1995, and then again between September and December of 1996. A total of 2364 S pneumoniae, 575 H influenzae and 200 M catarrhalis samples were collected. H influenzae and M catarrhalis isolates were tested for the production of beta-lactamase. S pneumoniae isolates were characterized as penicillin susceptible, intermediately resistant or high level penicillin-resistant. Minimal inhibitory concentrations (MICs) were determined using a microbroth dilution technique described by the National Committee of Clinical Laboratory Standards.
RESULTS: Between the two collection periods, there was a significant increase in highly penicillin-resistant S pneumoniae from 2.1% to 4.4% (P<0.05) and an increase in intermediately penicillin-resistant strains from 6.4% to 8.9% (P<0.05). A significant increase in high level penicillin-resistant S pneumoniae was noted among paediatric isolates. No significant difference in the susceptibilities of comparator agents was detected. A significant increase in the number of beta-lactamase producing H influenzae, 34% to 43% (P<0.05) was observed. Ninety-five per cent of M catarrhalis isolates were beta-lactamase producers in both time periods.
CONCLUSIONS: During the course of this study, the incidence of penicillin resistance in S pneumoniae doubled. As a result of this increase, infections due to this organism in sites where poor penetration of beta-lactam antibiotics occur may become increasingly difficult to manage.
METHODS: Fifty laboratories from across Canada were asked to collect up to 25 consecutive clinical isolates of S pneumoniae, H influenzae and M catarrhalis at some time between September 1994 and May 1995, and then again between September and December of 1996. A total of 2364 S pneumoniae, 575 H influenzae and 200 M catarrhalis samples were collected. H influenzae and M catarrhalis isolates were tested for the production of beta-lactamase. S pneumoniae isolates were characterized as penicillin susceptible, intermediately resistant or high level penicillin-resistant. Minimal inhibitory concentrations (MICs) were determined using a microbroth dilution technique described by the National Committee of Clinical Laboratory Standards.
RESULTS: Between the two collection periods, there was a significant increase in highly penicillin-resistant S pneumoniae from 2.1% to 4.4% (P<0.05) and an increase in intermediately penicillin-resistant strains from 6.4% to 8.9% (P<0.05). A significant increase in high level penicillin-resistant S pneumoniae was noted among paediatric isolates. No significant difference in the susceptibilities of comparator agents was detected. A significant increase in the number of beta-lactamase producing H influenzae, 34% to 43% (P<0.05) was observed. Ninety-five per cent of M catarrhalis isolates were beta-lactamase producers in both time periods.
CONCLUSIONS: During the course of this study, the incidence of penicillin resistance in S pneumoniae doubled. As a result of this increase, infections due to this organism in sites where poor penetration of beta-lactam antibiotics occur may become increasingly difficult to manage.
摘要：
目的：了解肺炎链球菌临床分离株的耐药性。来自加拿大各地医疗中心的流感嗜血杆菌和卡他莫拉菌。
方法：来自加拿大各地的50个实验室被要求收集多达25个连续的肺炎链球菌临床分离株，1994年9月至1995年5月期间的流感嗜血杆菌和粘膜炎菌，然后在1996年9月至12月期间再次出现。共有2364例肺炎链球菌，收集了575H流感和200M粘膜炎样品。测试了流感嗜血杆菌和粘膜炎菌分离株的β-内酰胺酶的产生。肺炎链球菌分离株的特征是青霉素敏感，中等抗性或高水平的青霉素抗性。使用由临床实验室标准的国家委员会描述的微量肉汤稀释技术测定最小抑制浓度(MIC)。
结果：在两个收集期之间，高度耐青霉素的肺炎链球菌从2.1％显着增加到4.4％（P<0.05），中间耐青霉素的菌株从6.4％增加到8.9％（P<0.05）。在儿科分离株中，高水平的耐青霉素肺炎链球菌显着增加。未检测到比较剂的敏感性存在显着差异。产生β-内酰胺酶的流感嗜血杆菌数量显著增加，观察到34％至43％（P<0.05）。在这两个时间段内，95%的粘膜炎菌分离物是β-内酰胺酶生产者。
结论：在本研究过程中，肺炎链球菌对青霉素耐药的发生率增加了一倍.由于这种增加，在β-内酰胺抗生素渗透不良的部位，由于这种细菌引起的感染可能变得越来越难以管理。
方法：来自加拿大各地的50个实验室被要求收集多达25个连续的肺炎链球菌临床分离株，1994年9月至1995年5月期间的流感嗜血杆菌和粘膜炎菌，然后在1996年9月至12月期间再次出现。共有2364例肺炎链球菌，收集了575H流感和200M粘膜炎样品。测试了流感嗜血杆菌和粘膜炎菌分离株的β-内酰胺酶的产生。肺炎链球菌分离株的特征是青霉素敏感，中等抗性或高水平的青霉素抗性。使用由临床实验室标准的国家委员会描述的微量肉汤稀释技术测定最小抑制浓度(MIC)。
结果：在两个收集期之间，高度耐青霉素的肺炎链球菌从2.1％显着增加到4.4％（P<0.05），中间耐青霉素的菌株从6.4％增加到8.9％（P<0.05）。在儿科分离株中，高水平的耐青霉素肺炎链球菌显着增加。未检测到比较剂的敏感性存在显着差异。产生β-内酰胺酶的流感嗜血杆菌数量显著增加，观察到34％至43％（P<0.05）。在这两个时间段内，95%的粘膜炎菌分离物是β-内酰胺酶生产者。
结论：在本研究过程中，肺炎链球菌对青霉素耐药的发生率增加了一倍.由于这种增加，在β-内酰胺抗生素渗透不良的部位，由于这种细菌引起的感染可能变得越来越难以管理。
