91株肺炎链球菌的血清型分布及耐药性分析

目的 了解重庆地区肺炎链球菌临床分离株的血清型分布及药物敏感性.方法 采用荚膜肿胀试验进行肺炎链球菌血清学分型,并计算疫苗(PVC7、PVC11、PVC13)覆盖率；肉汤稀释法测定抗菌药物的最低抑菌浓度(MIC).结果 91株肺炎链球菌的临床分离患者年龄呈典型双峰分布,以＜5岁婴幼儿与＞50岁中老年人群为主,占51.7％、27.5％;90株肺炎链球菌共鉴定出20个血清型,1株未能血清分型,常见的肺炎链球菌血清型为19F、19A、6B,PVC13覆盖率为74.4％；91株肺炎链球菌均表现出较高的耐药率,在67株β-内酰胺类抗菌药物不敏感株(BLAs)中,青霉素不敏感菌株(PNSP)占53.8％.结论 重庆地区肺炎链球菌临床分离株以19F、19A、6B血清型为主,PVC13的预防作用更显著；肺炎链球菌耐药性高尤其是大多数菌株呈多药耐药趋势,临床应注意合理选择用药.

Drug resistance and serotypes of 91 strains of Streptococcus pneumoniae

OBJECTIVE To investigate the antibiotics resistance and the prevalence of serotypes of Streptococcus pneumoniae isolated from the clinical patients in Chongqing.METHODS The capsular serotypes were identified by Quellung reaction and compared with the spectrum of the pneumococcal conjugate vaccine.Minimal inhibition concentrations(MICs) of the antibiotics were determined by the broth microdilution method.RESULTS The age profile of clinical patients infected by 91 strains of S.pneumoniae revealed a typical twin-peak distribution,with most patients being either <5 years old(51.7%) or ≥50 years old(27.5%).Among 91 clinical isolates,90 were divided into 20 serotypes and 1 was unable to serotype.The most prevalent serotypes of S.pneumoniae isolates were 19F,19A,6B,and PVC13 was expected to cover 74.4%.The majority of 91 isolates were resistant to common antibiotics.53.8% of 67 BLAs were penicillin non-susceptible S.pneumoniae.CONCLUSION The prevalent serotypes are 19F,19A,and 6B in Chongqing,and PVC13 is an effective vaccine to prevent the S.pneumoniae infections.The antibiotics resistance of S.pneumoniae strains is very serious,the majority of the isolates are multidrug-resistant,thus it is necessary to focus on the clinical reasonable use of antibiotics.