中国西部某二级医院呼吸道感染住院患儿鼻咽部肺炎链球菌中常见非PCV13血清型菌株的横断面调查

发布时间：2018-03-05 01:33

本文选题：肺炎链球菌　切入点：携带率　出处：《中国循证儿科杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的了解四川省中江县呼吸道感染住院患儿鼻咽部肺炎链球菌的定植状况及分离株的血清型分布和耐药性。方法 2015年1至12月采集四川省中江县人民医院儿科病房住院1月龄至14岁呼吸道感染患儿的鼻咽拭子并分离肺炎链球菌。用荚膜肿胀试验检测血清型,评估13价肺炎链球菌结合疫苗(PCV13)覆盖率。基于血清型随机选取约50%的菌株采用E-test法或纸片扩散法检测青霉素等16种抗生素的敏感性。结果共采集到1 082例鼻咽拭子,分离到肺炎链球菌199株,携带率18.4%。常见血清型为19F(14.6%)、19A(10.6%)、34(10.1%)、6A(9.0%)、23F(7.5%)、6B(7.5%)和23A型(7.0%)。PCV13覆盖率为54.8%。分离株对静脉青霉素敏感,但对口服青霉素敏感率仅为9.1%,对阿莫西林-克拉维酸敏感率为97%,对头孢曲松、万古霉素、左氧氟沙星和利奈唑胺敏感率100%,对红霉素和阿奇霉素均耐药。结论四川省中江县呼吸道感染患儿鼻咽部常有肺炎链球菌定植;分离株中非PCV13型别常见,以34和23A型为多,有必要加强监测;分离株对口服青霉素和红霉素等耐药率高,但对静脉青霉素、头孢曲松和万古霉素等普遍敏感。
[Abstract]:Objective to investigate the colonization of nasopharyngeal Streptococcus pneumoniae in hospitalized children with respiratory tract infection in Zhongjiang County, Sichuan Province, and the distribution of serotype and drug resistance of isolated strains. Methods from 2015 to December, the pediatrics of Zhongjiang County people's Hospital of Sichuan Province were collected. Nasopharynx swabs and Streptococcus pneumoniae were isolated from patients with respiratory tract infection aged from 1 month to 14 years in the ward. Serum serotype was detected by capsule swelling test. To evaluate the coverage of 13 valent streptococcus pneumoniae conjugated vaccine PCV13. About 50% strains were randomly selected based on serotype to detect the sensitivity of 16 antibiotics such as penicillin by E-test or disk diffusion. Results A total of 1 082 nasopharyngeal swabs were collected. 199 strains of Streptococcus pneumoniae were isolated, with a carrying rate of 18.4.The common serotypes were 19FC14.6 and 19FCU 10.6. The common serotypes were 19Fr. 10.6. The common serotypes were as follows: 23F7.05) and 23A. PCV13 were 54.85.The isolates were sensitive to intravenous penicillin, but were only 9.1to oral penicillin, 97m to amoxicillin, 97m to cetaxone, and 54.8.The isolates were sensitive to intravenous penicillin, but the sensitivity to oral penicillin was only 9.1, and the sensitivity rate to amoxicillin was 97.00%, and the sensitivity rate to cetaxone was 97%, and the rate of sensitivity to amoxicillin was 9.7%, and the rate of sensitivity to amoxicillin was 97%. Vancomycin, levofloxacin and linazolamine were sensitive to 100% and resistant to erythromycin and azithromycin. Conclusion Streptococcus pneumoniae is often colonized in nasopharynx of children with respiratory tract infection in Zhongjiang County, Sichuan Province. It is necessary to strengthen the monitoring of the isolates, the isolates have high resistance to oral penicillin and erythromycin, but are generally sensitive to intravenous penicillin, ceftriaxone and vancomycin.
【作者单位】：四川省中江县人民医院儿科;国家儿童医学中心首都医科大学附属北京儿童医院北京市儿科研究所儿科学国家重点学科国家呼吸系统疾病临床医学研究中心教育部儿科重大疾病研究重点实验室儿童呼吸道感染性疾病研究北京市重点实验室;四川省中江县人民医院检验科;
【基金】：国家自然科学基金:81371853 国家科学技术部项目:2013BAI09B11 北京市科委行业定额经费自主项目:2016-bjsekyjs-3
【分类号】：R446.5;R725.6

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