儿童来源的黏液型肺炎链球菌微生物学特征研究

摘要：目的 探索儿童来源的黏液型肺炎链球菌(Streptococcus pneumoniae)微生物学特征。方法 复活并重新鉴定2016—2019年我院保存的黏液型肺炎链球菌临床株,用E-test完成药敏试验,荚膜肿胀试验完成血清分型,并分析宿主临床特征。结果 共复活黏液型肺炎链球菌 21株,分别来自阻塞性睡眠呼吸暂停低通气综合征患儿切除的扁桃体和/或腺样体(47.6%)、肺炎患儿的深部痰液(28.6%)和肺泡灌洗液(14.3%)、阴道炎患儿的阴道分泌物(4.8%)等。血清分型示95.2%为3型,4.8%为37型。对青霉素、头孢呋辛、头孢曲松、哌拉西林、美罗培南、万古霉素、左氧氟沙星、复方磺胺甲恶唑和利福平敏感率为100%,对四环素和红霉素的耐药率为66.7%和100%。结论 我院儿童肺炎链球菌临床株中黏液型少见,血清3型为主,对β-内酰胺类抗生素敏感,对大环内酯类耐药。

Study of microbiological features of mucoid Streptococcus pneumoniae isolated from children

Abstract Objective To explore the microbiological features of mucoid Streptococcus pneumoniae (S.pneumoniae) isolated from children. Methods The clinical isolates of mucoid S. pneumoniae which were collectedbetween 2016 to 2019 were revived and re-identified. The antimicrobial susceptibility was measured by E-test,serotyping was completed by Quellung reaction, and clinical data was collected. Results 21 isolates of mucoid S.pneumoniae were revived, accounting for 3.20% of the total isolates in the same period. They were isolated as follows:10 (47.6%) from the resected tonsil or adenoid tissue in children with obstructive sleep apnea-hypopnea syndrome, 6(28.6%) from deep sputum, and 3 (14.3%) from alveolar lavage fluid in children with pneumonia, and 1(4.8%) fromvaginal swab in a child with vulvovaginitis and so on. 95.2% of them were serotype 3, and 4.8% were serotype 37.All isolates were found no resistance to penicillin, cefuroxime, ceftriaxone, meropenem, piperacillin, vancomycin,levofloxacin, trimethoprim sulfamethoxazole, and rifampin, while 66.7% of them were found resistant to tetracyclineand 100% resistant to erythromycin. Conclusions Mucoid S. pneumoniae is rarely isolated from children inour hospital and serotype 3 is the most common. They are highly susceptible to β-lactams, but highly resistant tomacrolides.