2010年至2017年苏州地区儿童肺炎链球菌的流行特点与耐药性研究

目的:探讨肺炎链球菌流行的分布特征及其耐药性的变化趋势，为临床合理使用抗菌药物提供依据。方法:回顾性分析2010年1月至2017年12月苏州大学附属儿童医院收集的呼吸道感染患儿痰标本中肺炎链球菌检出情况及其药物敏感试验结果。分别比较不同性别、年龄、年份和季节的肺炎链球菌检出率。采用Mann-Kendall趋势检验法分析...

Epidemiological characteristics and antibiotics susceptibility of Streptococcus pneumoniae isolated from children in Suzhou area during 2010 to 2017

Objective To explore the epidemiological characteristics and the antibiotic resistance of Streptococcus pneumoniae isolates,and to provide the evidence for the rational use of antimicrobial agents to treat Streptococcus pneumoniae infection.Methods The positive microbiological laboratory identification and antimicrobial susceptibility testing of Streptococcus pneumoniae from sputum of children with respiratory infections during January 2010 to December 2017 in Children′s Hospital of Soochow University were retrospectively analyzed.The positive rates of Streptococcus pneumoniae of different genders,ages,years and seasons were compared.The annual detection rates and trends of drug resistance of Streptococcus pneumoniae to penicillin,amoxicillin and cefotaxime were analyzed by Mann-Kendall trend test.The seasonal decomposition of time series was conducted to assess the association between Streptococcus pneumoniae detection rate and season.Enumeration data was compared using x²test.Results Of the 88480 sputum specimens,the total positive rate of Streptococcus pneumoniae was 10.3%(9081/88480).The detection rates of Streptococcus pneumoniae in children aged 0 to<0.5 years old,0.5 to<2 years old,2 to<3 years old,3 to<5 years old,and 5 to<15 years old were 4.2%(1407/33224),13.1%(3191/24390),14.9%(2417/16252),17.9%(1474/8246)and 9.3%(592/6368),respectively.The difference was statistically significant(x²=2421.6,P<0.01).The detection rates were 8.1%(1321/16306)from January to March,10.9%(2194/20207)from April to June,8.5%(2141/25058)from July to September,and 12.7%(3425/26909)from October to December.The discrepancy of positive rates in different seasons showed statistical significance(x²=311.5,P<0.01).During 2010 to 2017,significant decreases in antibiotic resistant rates of Streptococcus pneumoniae to penicillin,amoxicillin and cefotaxime were detected(tau=-0.93,-0.93 and-0.71,respectively,all P<0.05).Conclusions The detection rate of Streptococcus pneumoniae in sputum of children with respiratory infections may present seasonal pattern and vary between different ages of children.The resistance toβ-lactam antibiotics has declined.