上呼吸道感染患儿肺炎链球菌血清群/型及耐药分析

目的了解患上呼吸道感染的0~5岁儿童肺炎链球菌的血清群/型及其对抗生素耐药情况。探讨肺炎链球菌疫苗在中国儿童使用的意义。方法取患儿鼻咽分泌物,分离出137株肺炎链球菌。采用荚膜肿胀法(Quellinngtest)进行血清群/型分析。E-test及K-B纸片扩散法检测对青霉素等13种抗生素的敏感性。结果疫苗相关血清型占63%,最常见的血清群/型为19、6、23、14。青霉素不敏感率为33%,较往年增高。青霉素耐药菌株对头孢类抗生素有交叉耐药性,红霉素、阿奇霉素耐药率达94%,应引起临床高度重视。结论疫苗相关血清群/型在0~5岁儿童覆盖率较高,肺炎链球菌疫苗的使用有利于降低儿童肺炎链球菌感染的发病率,有助于减少抗生素耐药的产生。

Serotyping/Grouping and Antimicrobial Resistance of Streptococcus Pneumoniae From Children With Upper Respiratory Infection

Objective To evaluate streptococcus pneumonia serotypes and antimicrobial resistance in children and discuss the significance for vaccination.Methods 137 strains isolated from nasopharyngeal swabs of 0-5 years old patients with upper respiratory disease were serotyped using capsular swelling test.The antimicrobial resistance were analysized with E-test and Kirdy-Bauer method.Results The 7-valent pneumoccal conjugate vaccine related serotypes/groups were found in 63% of the isolates.The most prevalent serogroups/serotypes are 19,6,23,and 14.Penicillin non-susceptable rate is 33%,showing an increasing trend compared to previous years.Pecilline resistance strains showed a cross-resistance to some cefsporins.Erythromycin and azthromycin resistance covered 94% of isolates,calling for clinical attention.Conclusion High prevalence of vaccine related serotypes/groups among children with upper respiratory infection suggested the need of vaccination to prevent the strepcoccal pneumoniae infection disease and it is helpful in reducing reduce the antibiotic resistance.