住院患儿细菌培养标本分离肺炎链球菌特征分析

发布时间：2018-07-31 13:51

【摘要】：目的分析住院患儿细菌培养标本中所检出肺炎链球菌的分布、血清型及耐药性特征。方法收集2013年3月至2014年2月在首都医科大学附属北京儿童医院呼吸、感染及重症监护病房住院的195例患儿送检的细菌培养标本,对其进行肺炎链球菌常规检测、血清分型和药物敏感性试验。按照2013年临床实验室标准化委员会(CLSI)推荐的抗菌药物敏感性试验标准进行结果判断。应用WHONET 5.6软件对药敏结果进行耐药性分析。结果 195例患儿分离到肺炎链球菌,其中婴幼儿占66.1%。195例中共检出20种血清型,其中19F最多,占32.3%,其次19A,占20.5%。肺炎链球菌对红霉素和克林霉素最不敏感(敏感率5%),对青霉素不敏感率为46.7%。与对青霉素敏感的肺炎链球菌进行抗菌药物耐药性比较后显示,青霉素不敏感肺炎链球菌对头孢噻肟、头孢吡肟、美罗培南和复方新诺明不敏感率均高于敏感菌株,差异存在统计学意义(P0.05)。结论在儿科,肺炎链球菌的检出、流行型别的确定以及耐药性检测均不容忽视,应进行疫苗预防接种和合理选择抗菌药物进行抗感染治疗。
[Abstract]:Objective to analyze the distribution, serotype and drug resistance of Streptococcus pneumoniae in bacterial culture samples of hospitalized children. Methods from March 2013 to February 2014, 195 samples of bacterial culture were collected from Beijing Children's Hospital affiliated to Capital Medical University and hospitalized in intensive Care Unit (ICU). The samples were detected by routine detection of Streptococcus pneumoniae (Streptococcus pneumoniae). Serum typing and drug sensitivity test. The results were judged according to the antimicrobial sensitivity test recommended by the Clinical Laboratory Standardization Committee (CLSI) in 2013. Drug resistance was analyzed by WHONET 5.6 software. Results among 195 cases of streptococcus pneumoniae, 20 serotypes were detected in infants and infants (66.1.195), in which 19F was the most, 32.3%, followed by 19A (20.5A). Streptococcus pneumoniae was the most insensitive to erythromycin and clindamycin (5%) and 46.7% to penicillin. Compared with the antibiotic resistance of penicillin sensitive Streptococcus pneumoniae, penicillin insensitive Streptococcus pneumoniae showed higher insensitivity to cefotaxime, cefepime, meropenem and compound sulfamethoxine. The difference was statistically significant (P0.05). Conclusion in pediatrics, the detection of Streptococcus pneumoniae, the determination of epidemic type and the detection of drug resistance should not be ignored.
【作者单位】：首都医科大学附属北京儿童医院儿科学国家重点专科国家呼吸系统疾病临床医学研究中心检验科;首都医科大学附属北京儿童医院儿科学国家重点专科国家呼吸系统疾病临床医学研究中心呼吸内科;首都医科大学附属北京儿童医院儿科学国家重点专科国家呼吸系统疾病临床医学研究中心重症监护室;首都医科大学附属北京儿童医院儿科学国家重点专科国家呼吸系统疾病临床医学研究中心感染科;首都医科大学附属北京儿童医院儿科学国家重点专科国家呼吸系统疾病临床医学研究中心北京市儿科研究所;
【基金】：国家科技部国家呼吸系统疾病临床医学研究中心课题(2013BAI09B11)
【分类号】：R446.5;R725

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