武汉地区肺炎链球菌的红霉素耐药性分析及血清分型研究

目的 研究武汉地区肺炎链球菌的红霉素耐药率、耐药表型及肺炎链球菌血清分型分布情况.方法 以琼脂稀释法测定红霉素、青霉素及其他大环内酯类等抗菌药物对304株肺炎链球菌的最低抑菌浓度(MIC),采用荚膜肿胀试验进行血清分型,以双纸片法测定红霉素耐药菌株的耐药表型.结果 304株肺炎链球菌红霉素耐药率高达84.21%(256/304).红霉素耐药菌株中,cMLSB型耐药占98.44%(252/256),M型耐药仅占1.56%(4/256).血清分型涉及20个血清型、群,主要集中在19、23、6、15和14血清群,其中PNSSP集中分布在6、19、23和未分型血清群.结论 武汉地区红霉素不敏感肺炎链球菌的发生率较高,其耐药表型以cMLSB型为主,双纸片法对此耐药表型的检测有很好的预见性.血清分型,尤其多重耐药菌株以6、19和23血清群为主,推荐采用疫苗免疫预防肺炎链球菌感染.

Study on the Serotyping and Resistance to erythromycin of Streptococcus pneumoniae in Wuhan

Objective Objective To investigate the serotyping,resistance to erythromycin and resistance phenotypes of Streptococcus pneumoniae in Wuhan.Methods 304 strains of Streptococcus pneumoniae were tested by agar dilution method according to the approved standard of NCCLS to determine their susceptibility to erythromycin,penicillin,various macrolides,and so on.Serotyping of Streptococcus pneumoniae was performed by capsule swelling test.Phenotyping was done by the double-disk diffusion method.Results The percentage of nonsusceptilibity of Streptococcus pneumoniae to erythromycin has reached 84.21%(256/304).cMLSB-phenotype was the prevalent phenotype,the percentage of which was 99.84%(252/256).Only 4 strains were M-phenotype.20 serotypes were involved in 304 strains Streptococcus pneumoniae.The prevalent serotypes were 19,23,6,15 and 14.All penicillin-unsusceptible Streptococcus pneumoniae were included in 6,19 and 23 serotype.Conclusion The rate of erythromycin-nonsusceptilibity Streptococcus pneumoniae was high in Wuhan.Double-disk diffusion method can well detect its phenotype.The prevalent serotypes,especially the multi-resistant strains,were 19,23 and 6 serotype.Pneumococcal Polyvalent Vaccine can well cover these serotypes.