健康6月龄内儿童肺炎链球菌携带状况及耐药特征分析

目的 了解济南地区健康6月龄内儿童鼻咽部肺炎链球菌携带血清型及耐药特征,为肺炎球菌疫苗推广接种提供数据。方法 2019年11月—2020年4月采集济南地区216例健康6月龄内儿童鼻咽拭子,经分离培养获得疑似肺炎链球菌菌株;利用基质辅助激光解吸电离飞行时间质谱和奥普托欣敏感试验鉴定后,采用多重PCR方法明确肺炎链球菌血清型;进一步采用微生物药敏分析仪进行药物敏感性检测。结果 216例健康6月龄内儿童肺炎链球菌携带率为5.1%(11/216),共携带7种血清型：15B、23F、6B、8、18C、19F和13。13价肺炎球菌多糖结合疫苗血清型覆盖率为54.5%,23价肺炎球菌多糖疫苗覆盖率为90.9%。19种抗生素中红霉素和阿奇霉素耐药率为100.0%;耐药率80.0%以上的有四环素、克林霉素、甲氧苄胺嘧啶/磺胺甲噁唑;头孢呋辛和青霉素(口服)的耐药率超过50.0%。万古霉素、利奈唑胺、左氧氟沙星、氯霉素和莫西沙星未发现耐药菌株。11例儿童鼻咽部肺炎链球菌分离株显示多重耐药,耐药种类3～6种。结论 济南地区健康6月龄内儿童鼻咽部定植的肺炎链球菌具有多种血清型,且抗生素耐药现象较严重。     

北京市怀柔区2～5岁儿童肺炎链球菌鼻咽带菌率现状及7价肺炎球菌结合疫苗效果研究

目的了解北京市怀柔区2～5岁健康儿童肺炎链球菌鼻咽部携带现状并评价7价肺炎球菌结合疫苗(PCV7)对预防肺炎链球菌鼻咽携带的效果。方法抽取怀柔区2～5岁未接种过PCV7疫苗的健康儿童,分为PCV7接种组和对照组,采集3次鼻咽拭子进行肺炎链球菌培养,评估肺炎链球菌鼻咽携带基线水平,并比较2组肺炎链球菌鼻咽带菌率差异。结果共472名受试儿童,接种组235人,对照组237人,472名研究对象中检出肺炎链球菌阳性103名,携带率为21.82%;36～48月龄组携带率最高,显著高于24～36月年龄组(P=0.004);在不同的时间点,接种组和对照组的肺炎链球菌鼻咽携带率差异无统计学意义(P=0.715);疫苗接种总体不良反应发生率为8.76%,轻度反应(1级)最多(6.41%),局部和全身不良反应发生率分别为3.63%和5.13%。结论建立了怀柔区2～5岁儿童肺炎链球菌鼻咽部携带率基线资料;接种PCV7对降低2～5岁儿童鼻咽部肺炎链球菌携带率的效果不显著;以2～5岁儿童接种PCV7后,安全性良好。     

健康儿童接种7价肺炎链球菌结合疫苗可减少该菌所致的疾病

健康儿童鼻咽部肺炎球菌的无症状携带很常见,一种包含常见致病菌血清型的7价肺炎链球菌结合疫苗能有效避免鼻咽部携带肺炎链球菌。作者评价了健康儿童鼻咽部肺炎链球菌的流行率,测定了其对多种抗生素的耐药性,找出了引起携带的危险因素,并阐明了1岁以内儿童接种该疫苗的意义。 方法:2000年4月15日～6月15日,选择意大     

武汉市健康婴儿鼻咽部肺炎链球菌及流感嗜血杆菌定植状况的调查

目的了解武汉市健康婴儿鼻咽部肺炎链球菌、流感嗜血杆菌的定植状况。方法抽取6个预防接种门诊,采集受种健康婴儿鼻咽部标本,进行肺炎链球菌、流感嗜血杆菌的培养。结果998名受检健康婴儿鼻咽部肺炎链球菌、流感嗜血杆菌携带率为18.84%、17.54%,6月龄以内的肺炎链球菌、流感嗜血杆菌的携带率为15.79%、14.39%,7~12月龄的肺炎链球菌、流感嗜血杆菌的携带率为22.90%、21.73%,差异有统计学意义(Sp:χ2=5.60,P=0.02;Hi:χ2=8.98,P=0.00);城区、郊区肺炎链球菌携带率为18.08%、19.78%,流感嗜血杆菌携带率为17.18%、17.98%,差异无统计学意义(Sp:χ2=0.47,P=0.50;Hi:χ2=0.11,P=0.74);月龄与Sp、Hi携带率的相关系数(r值)为0.98、0.96。结论武汉市健康婴儿月龄与肺炎链球菌、流感嗜血杆菌携带率呈高度线性正相关。     

柳州市健康儿童鼻咽部肺炎链球菌的耐药性分析

摘要:目的　了解本地区学龄儿童鼻咽部肺炎链球菌携带情况及该菌对抗生素药物敏感性。方法　选取在某院行健康体检的2～12岁儿童1475人,采集鼻咽拭子标本后,进行肺炎链球菌分离鉴定。奥普托欣实验用于鉴定,并对阳性细菌进行抗生素耐药性检测。结果　共纳入幼儿园儿童684名,小学儿童791名,幼儿园、小学儿童鼻咽部分离到肺炎链球菌85株和63株,其携带率分别为12.4%及8.0%。幼儿园儿童肺炎链球菌携带率比小学生高（χ2＝8.09,P＝0.004）,幼儿园儿童鼻咽部携带的肺炎链球菌菌株对红霉素及四环素的耐药性均比小学儿童高,其差异有统计学意义（χ2红＝3.91,P＝0.048;χ2四＝4.50,P＝0.034）;小学儿童鼻咽部携带的肺炎链球菌菌株对克林霉素及复方新诺明的耐药性高于幼儿园儿童（χ2克＝5.54,P＝0.019;χ2复＝15.49,P＜0.001）。结论　柳州市健康儿童肺炎链球菌携带率较高,肺炎链球菌对红霉素、克林霉素的耐药率均在59%以上,红霉素、克林霉素已不能作为治疗肺炎链球菌的经验用药。有必要加强对健康儿童鼻携带的肺炎链球菌进行全国性的监测,为临床医生合理用药提供科学依据。     

肺炎链球菌疫苗在不同年龄组儿童中应用价值分析

目的根据感染患儿来源的肺炎链球菌血清型分布特征,初步评价不同肺炎链球菌疫苗在相对应年龄组儿童中的应用价值。方法参考文献对2014年收集到的182株肺炎链球菌菌株提取DNA,应用多重PCR方法进行分型,分析不同疫苗血清型比例。结果从河北省儿童医院的182株肺炎链球菌菌株中19F和19A型数量最多,分别为68株(占37.36%)和33株(占18.13%),其次较多的型别有6B、35B型、14型、23F型、15B/15C型等。7价、10价、13价肺炎链球菌结合疫苗所含血清型在2岁以下儿童来源菌株中分别占61.33%、61.33%、82.67%。所有2岁以上儿童来源菌株中81.25%属于23价肺炎链球菌多糖疫苗血清型。结论本研究中肺炎链球菌血清型分布存在以19F、19A型为主同时兼有多样性的特点。针对不同年龄组儿童应用结合疫苗或多糖疫苗都将取得一定的免疫效果。     

152株肺炎链球菌的耐药性及血清分型研究

目的 了解武汉地区肺炎链球菌对常用抗菌药物的耐药性及血清型分布.方法 琼脂稀释法测定152株肺炎链球菌对15种抗菌药物最低抑菌浓度,荚膜肿胀试验进行血清学分型.结果 152株肺炎链球菌中,耐青霉素肺炎链球菌（PRSP,MIC≥0.12 mg/L）的发生率为42.76%;第一、二、三代头孢菌素的耐药率依次降低,分别为94.08%、50.66%、41.45%和11.18%;红霉素、四环素、复方新诺明和氯霉素耐药率分别为84.21%、88.82%、89.47%和18.42%;新喹诺酮类左氧氟沙星和莫西沙星的耐药率均为1.32%;血清分型共涉及20个血清型、群,主要集中在19、23、6、15和14血清群,PRSP分布在6、19、23和未分型血清群.结论 武汉地区肺炎链球菌耐药性高,应注意合理选择用药;血清分型,尤其多重耐药株以6、19和23血清群为主,推荐疫苗免疫预防肺炎链球菌感染.     

2016年中山市6~13岁学龄儿童鼻咽部肺炎链球菌携带情况及药物敏感性分析

目的 了解中山市6~13岁学龄儿童鼻咽部肺炎链球菌携带情况及药物敏感性情况。 方法 2016年10-12月期间对中山市3所小学的学生进行调查,按各校的学生总人数和各年级的学生人数情况进行抽样,共选取253名学龄儿童,采集咽拭子,检测肺炎链球菌并开展药敏试验。 结果 年龄为6～、9～、12～13岁儿童肺炎链球菌阳性携带率分别为12.8%(10/78)、15.89%(17/107)、7.35%(5/68),各年龄段相比差异有统计学意义(χ²=9.441, P=0.043),各年龄段不同性别的肺炎链球菌携带率比较差异无统计学意义(P＞0.05)。50株肺炎链球菌对阿莫西林和左氧氟沙星的敏感性高达100%,对头孢曲松和氯霉素也有较高的敏感性;而对红霉素和阿奇霉素的耐药性高达96.00%,对四环素耐药性高达78.00%。 结论 2016年中山市6~13岁学龄儿童鼻咽部肺炎链球菌携带普遍,且对阿莫西林、左氧氟沙星、青霉素、头孢曲松和氯霉素敏感性较高。     

马鞍山市肺炎链球菌血清型分布及耐药性分析

目的了解马鞍山地区肺炎链球菌临床分离株的血清型分布及药物敏感性。方法应用奥普脱欣试验及胆汁溶解试验鉴定肺炎链球菌;采用荚膜肿胀试验进行肺炎链球菌血清学分型,计算PPV23价疫苗及PCV7疫苗覆盖率;K-B法测定8种药物的耐药试验。结果 80株肺炎链球菌共鉴定13种血清型,有5株不能定型或群,马鞍山地区相对的优势血清型以19F、19A、23F为主,PPV23价疫苗可覆盖本次测试株的86.42%,PCV7疫苗可覆盖测试株的55.56%血清型;75株测试菌对青霉素等药物耐药率较高,耐受四种以上药物的菌株达60株,占测试菌株的80.00%,所有测试菌对左氧氟沙星和万古霉素全部敏感。结论马鞍山地区肺炎链球菌临床分离株以19F、19A、23F血清型为主,PPV23价疫苗的预防作用更显著;绝大多数肺炎链球菌呈多药耐药趋势,应注意合理用药。     

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.     

接种13价肺炎球菌结合疫苗对就诊儿童肺炎链球菌血清型和耐药性的影响

目的 了解就诊儿童肺炎链球菌(Streptococcus pneumoniae, Spn)血清型分布和耐药特征,探索接种13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine, PCV13)对Spn的影响。方法 收集2017―2019年苏州大学附属儿童医院疫苗接种信息明确的就诊儿童的Spn菌株,根据疫苗接种情况进行分组,并采用荚膜肿胀法进行血清分型,E-test法检测菌株抗生素的耐药性,比较是否接种PCV13对Spn血清型和耐药性的差别。结果 共收集692株Spn,其中20株分离自接种PCV13儿童。接种组中常见的血清型为19F、6B、19A、23F,对照组中常见的血清型为19F、6B、23F、19A、14,两组血清型分布差别无统计学意义(P=0.868),PCV13血清型覆盖率分别为70.0%和72.4%(P=0.491)。所有菌株对红霉素、四环素、克林霉素高度耐药,且多重耐药率达98.5%。接种组和对照组的Spn菌株对青霉素的不敏感率分别为5.0%和9.1%(P=0.804)。结论 苏州大学附属儿童医院监测就诊儿童Spn血清型以PC...     

Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children: implications for the use of heptavalent pneumococcal conjugate vaccine

We assessed the prevalence of Streptococcus pneumoniae serotypes in the nasopharynx of healthy children, antimicrobial susceptibility patterns, risk factors for carriage, and the coverage of heptavalent pneumococcal conjugate vaccine. In 2,799 healthy infants and children, the S. pneumoniae carrier rate was 8.6% (serotypes 3, 19F, 23F, 19A, 6B, and 14 were most common). Most pneumococci (69.4%) were resistant to one or more antimicrobial classes. The rate of penicillin resistance was low (9.1%); macrolide resistance was high (52.1%). Overall, 63.2% of the isolates belonged to strains covered by the heptavalent pneumococcal vaccine. This percentage was higher in children <2 years old (73.1%) and in those ages 2-5 years (68.9%). Sinusitis in the previous 3 months was the only risk factor for carrier status; acute otitis media was the only risk factor for the carriage of penicillin-resistant S. pneumoniae. Most isolated strains are covered by the heptavalent conjugate vaccine, especially in the first years of life, suggesting that its use could reduce the incidence of pneumococcal disease.     

Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus isolated from the nasopharynx of healthy children attending day-care centres in the Czech Republic

Nasopharyngeal carriage of potential pathogens was studied in 425 healthy 3- to 6-year-old children attending 16 day-care centres (DCCs) in nine Czech cities during the winter 2004-2005. The overall carriage of pathogens was 62.8% (Streptococcus pneumoniae, 38.1%; Haemophilus influenzae, 24.9%; Moraxella catarrhalis, 22.1%; Staphylococcus aureus, 16%). An age-related downward trend was observed for colonization with respiratory pathogens in contrast to Staph. aureus whose carriage was significantly higher among older children. The following serotypes of colonizing S. pneumoniae were the most predominant: 23F (20.6%), 6A (15.1%), 6B (12.7%), 18C (7.8%), 15B and 19F (6% each). The majority (94.3%) of H. influenzae isolates were non-typable; among capsulated isolates, serotype b was not found. Decreased susceptibility to penicillin was determined in 3% of pneumococci; 4.6% of H. influenzae strains and 85.1% of M. catarrhalis strains produced beta-lactamase. As for non-beta-lactam antibiotics, pneumococci resistant to trimethoprim-sulphamethoxazole were the most common (15.7%) among the attendees.     

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...     

Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children, 2 to 24 months of age, in New-Caledonia

OBJECTIVES: The aims of this study were to determine the prevalence of pneumococcal nasopharyngeal carriage in New-Caledonian children less than two years of age, to define risk factors for carriage, and to document the serotypes present in New Caledonia prior to the implementation of the conjugate pneumococcal vaccine. METHOD AND RESULTS: From August 2002 to April 2003, nasopharyngeal samples were collected on 1040 children less than two years of age during scheduled visits to dispensaries for routine immunization. Of the 1040 samples, 544 (52%) were positive for Streptococcus pneumoniae. The percentage of pneumococcal strains with reduced susceptibility to penicillin (PRSP) was 21%. Several risk factors for pneumococcal carriage were identified. These included the Province that the child lived in, the ethnic group, age, and having a sibling less than 6 years of age. Risk factors for carriage of PRSP carriage were similar but also included additional risk factors such as attendance at day care and a history of antibiotic treatment. The eight most frequent serotypes were 6B, 19F, 14, 23F, 6A, 19A, 11A, and 16F. These serotypes accounted for 60% of all strains detected. The most frequent serotypes of PRSP were 14, 9 V, 19F, 23F, and 6B. They were more often identified in european children and 80% were vaccine serotypes. However, overall 250/544 (46%) of all pneumococcal isolates were those included in the 7 serotype vaccine.     

河北省肺炎链球菌疫苗在不同年龄组儿童中应用价值分析

目的：根据感染患儿来源的肺炎链球菌血清型分布特征,初步评价不同肺炎链球菌疫苗在相对应年龄组儿童中的应用价值。方法：参考文献对2014年收集到的182株肺炎链球菌菌株提取DNA,应用多重PCR方法进行分型,分析不同疫苗血清型比例。结果：所有菌株中19F和19A型数量最多,分别为68株（占37.36%）和33株（占18.13%）,其次较多的型别有6群、35B型、14型、23F型、15B/15C型等。7价、10价、13价肺炎链球菌结合疫苗所含血清型在2岁以下儿童来源菌株中分别占61.33%、61.33%、82.67%。所有2岁以上儿童来源菌株中81.25%属于23价肺炎链球菌多糖疫苗血清型。结论：本研究中肺炎链球菌血清型分布存在以19F、19A型为主同时兼有多样性的特点。针对不同年龄组儿童应用结合疫苗或多糖疫苗都将取得一定的免疫效果。     

241株肺炎链球菌血清分型及耐药性研究

目的了解肺炎链球菌（Streptococcus pneumoniae,S．p）对常用抗菌药物的敏感性及血清型构成。方法采用纸片扩散法检测241株S．P对6种常用抗菌药物的敏感性;采用荚膜肿胀试验对菌株进行血清学分型。结果241株s．p对利福平、米诺环素、氧氟沙星、复方新诺明、阿奇霉素、氯霉素的耐药率分别为0．41％、77．18％、0％、78．00％、95．44％、22．00％。229株S．P可分为24个血清型／群,主要的流行血清型／群为19F、6B、19A、23F、15、14、6A、3、6C;12株s．p未能分型。多重耐药菌株分布在6B、19A、19F、23F血清型。结论S．P的耐药情况严重,大多数菌株呈多重耐药特征。     

Competition among Streptococcus pneumoniae for intranasal colonization in a mouse model

Widespread use of conjugate vaccines against Streptococcus pneumoniae, by reducing carriage of S. pneumoniae serotypes included in the vaccine, may result in an increase in nasopharyngeal carriage of - and disease from - nonvaccine serotypes of the same species. Mathematical models predict that the extent of such replacement will depend positively on the degree to which carriage of vaccine-type S. pneumoniae inhibits acquisition of nonvaccine-type pneumococci, and may depend negatively on the inhibition of vaccine-type pneumococci by nonvaccine-type pneumococci. We used a mouse model of intranasal carriage of pneumococci to test whether such inhibition occurs between different pneumococcal strains. Mice carrying a streptomycin-resistant derivative of S. pneumoniae BG9163 (serotype 6B) as a resident strain showed reduced levels of colonization when challenged intranasally by optochin-resistant derivatives of the same strain and of a serotype 23F pneumococcus, BG8826. Inhibition could be overcome by increasing the dose of the challenge strain. Carriage of optochin-resistant BG9163 did not inhibit acquisition of the streptomycin-resistant variant. Colonization by a challenge strain did not significantly affect the level of colonization with the resident strain. These results provide evidence that is consistent with several hitherto untested assumptions of mathematical models of serotype replacement and suggest that a biological mechanism exists that could account for serotype replacement that is observed in clinical trials. The findings provide a basis for further studies of in vivo interactions between strains of S. pneumoniae.