摘要
目的了解首都医科大学附属北京儿童医院住院患儿肺炎链球菌分离株的血清型分布和耐药性,以指导临床合理用药。方法采用荚膜肿胀试验对首次分离的肺炎链球菌进行血清型分型,用纸片法和BD Phoenix 100全自动微生物仪进行药敏试验。结果 2013年3月-2019年2月共收集非重复肺炎链球菌834株,主要分离自3岁以下患儿(612株,73.4%)。患儿以肺部感染为主(739例,88.6%)。834株肺炎链球菌中分离自脑脊液菌株19株;侵袭性菌株和非侵袭性菌株分别为90 株和744株。共检出43种血清型,常见的血清型为19F、19A、23F、14、6A、6B。青霉素敏感株(PSSP)354株(42.4%),青霉素不敏感株(PNSP)480株(57.6%);未发现利奈唑胺和万古霉素耐药株。肺炎链球菌对莫西沙星、左氧氟沙星和氯霉素的敏感率高(>95%);但对红霉素、克林霉素和四环素的耐药率高(>94%)。侵袭性菌株和非侵袭性菌株对抗菌药物的耐药率差异无统计学意义。血清型为19F和19A的菌株对多种抗菌药物的耐药率明显高于其他血清型菌株。PNSP对多种抗菌药物的耐药率高于PSSP。结论该院住院患儿感染肺炎链球菌血清型以19F、19A、23F、14、6A、6B为主,对莫西沙星、左氧氟沙星和氯霉素的耐药率低,对红霉素、克林霉素和四环素的耐药率高。血清型19F和19A的菌株对抗菌药物的耐药率高于其他血清型菌株。应加强细菌耐药性监测,根据患儿感染细菌的血清型和药敏试验结果合理选用抗菌药物。
Objective To investigate the serotype and antimicrobial resistance profiles of Streptococcus pneumoniae isolates from the children hospitalized in Beijing Children’s Hospital,Capital Medical University for rational antimicrobial therapy.Methods The serotypes of S.pneumoniae isolates were identified by capsule swelling experiment.Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System.Results A total of 834 isolates of S.pneumoniae were collected from March 2013 to February 2019,most (73.4%) of which were from children under 3 years old,with pulmonary infection as the main clinical manifestation.There were 90 invasive strains and 744 non-invasive strains,including 19 meningitis strains.Overall,43 serotypes were detected.The most common serotypes were 19F,19A,23F,14,6A,and 6B.Susceptibility testing showed 354 penicillin-susceptible S.pneumoniae (PSSP) strains and 480 penicillin-non-susceptible S.pneumoniae (PNSP) strains.No strains were found resistant to vancomycin or linezolid.The sensitive rate of S.pneumoniae strains were highly susceptible (>95%) to moxifloxacin,levofloxacin and chloramphenicol,but highly resistant (>94%) to erythromycin,clindamycin and tetracycline.Invasive and non-invasive strains did not show significant difference in antibiotic resistance.Serotypes 19F and 19A demonstrated significantly higher resistance rates to a number of antimicrobial agents than other serotypes.PNSP strains were apparently more resistant than PSSP strains.Conclusions The main serotypes of S.pneumoniae isolates from children are 19F,19A,23F,14,6A,and 6B,which are relatively sensitive to moxifloxacin,levofloxacin and chloramphenicol,but highly resistant to erythromycin,clindamycin,and tetracycline.Serotypes 19F and 19A were more resistant than other serotypes.It is necessary to strengthen the surveillance of bacterial resistance and select antibiotics reasonably according to the serotype and susceptibility test results of S.pneumoniae.
作者
吕志勇
董方
宋文琪
甄景慧
袁林
苏建荣
LV Zhiyong;DONG Fang;SONG Wenqi;ZHEN Jinghui;YUAN Lin;SU Jianrong(Department of Laboratory Medicine,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing,100045,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2020年第4期417-422,共6页
Chinese Journal of Infection and Chemotherapy
关键词
肺炎链球菌
儿童
血清型
耐药性
Streptococcus pneumoniae
children
serotype
antibiotic resistance
