2017-2019年苏州地区儿童肺炎链球菌血清分型及耐药特征

  目的  了解苏州大学附属儿童医院呼吸道感染儿童肺炎链球菌菌株的血清型分布及耐药特征，为制定肺炎链球菌相关疾病的治疗和预防接种策略提供参考。  方法  采用乳胶凝集和荚膜肿胀试验对肺炎链球菌菌株进行血清分型，采用E-test法检测菌株对多种抗生素的耐药性。  结果  2017年1月-2019年7月共收集3 652株肺炎链球菌，主要来自于6月龄~2岁年龄段儿童，男女性别比为1.5:1。常见血清型为19F、6B、23F、19A及6A，13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine, PCV13)的血清型覆盖率为73.1%(95% CI:71.6%~74.5%)。肺炎链球菌菌株对青霉素的耐药率为1.9%。青霉素不敏感肺炎链球菌(penicillin-non susceptible streptococcus pneumoniae, PNSP)(含中介和耐药菌株)对阿莫西林、红霉素、阿奇霉素等抗菌药物的耐药率高于青霉素敏感肺炎链球菌(penicillin-susceptible streptococcus pneumoniae, PSSP)菌株；PCV13疫苗血清型菌株的耐药率高于非疫苗血清型菌株。  结论  苏州地区儿童肺炎链球菌分离株PCV13疫苗血清型覆盖较高，且青霉素不敏感菌株大多为PCV13疫苗血清型。

Serotype distribution and antimicrobial susceptibility of streptococcus pneumoniae isolated from children in Suzhou from 2017 to 2019

Objective To investigate the serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae(S. pneumoniae) isolated from children with respiratory infectious diseases in Soochow University Affiliated Children’s Hospital, so as to provide evidences for treatment and vaccination strategies of pneumococcal disease. Methods S. pneumoniae strains were serotyped by latex agglutination and quellung reactions, and were detected the susceptibility of multiple antibiotics with E-test method. Results From Jan 2017 to Jul 2019, a total of 3 652 pneumococci were collected. The strains were mainly isolated from 6-month to 2-year old children, with a male to female ratio of 1.5∶1. The common serotypes were 19 F, 6 B, 23 F, 19 A and 6 A, and the coverage of serotypes included in 13-valent pneumococcal conjugate vaccine(PCV13)was 73.1%(95% CI: 71.6%-74.5%). The penicillin resistance rate was 1.9%. Among the penicillin non-susceptible(PNSP) strains, the rates of resistant to amoxicillin, erythromycin and azithromycin were higher than those of the penicillin susceptible S. pneumoniae(PSSP) strains. The antibiotics resistance rate of strains included in PCV13 serotype was higher than that of the strains not covered by PCV13 vaccine serotype. Conclusions The coverage of PCV13 vaccine serotypes was high among the S. pneumoniae isolated from children in Suzhou, and most of the penicillin non-susceptible strains were covered by the PCV13 vaccine serotypes.