1997-2007年上呼吸道感染患儿鼻咽部6群肺炎链球菌分离株的耐药性变化  

Changing antibiotic resistance pattern of serogroup 6 Streptococcus pneumoniae isolated from children with upper respiratory infection during the period from 1997 to 2007

作　　者：刘尊杰[1] 姚开虎[1] 袁林[1] Yu Jigui 高薇[1] 俞桑洁[1] Moon H．Nahm 杨永弘[1] 

机构地区：[1]首都医科大学附属北京儿童医院儿科研究所,100045 [2]Departments of Pathology and Microbiology, Universityof Alabama at Birmingham, Birmingham, Alabama,美国AL35294

出　　处：《中国感染与化疗杂志》2010年第3期182-187,共6页Chinese Journal of Infection and Chemotherapy

基　　金：科技支撑计划课题(2008BAI66B01);北京市科技新星项目(2008B64)

摘　　要：目的明确1997—2007年分离自北京儿童医院门诊上呼吸道感染患儿鼻咽部的6群肺炎链球菌的型别构成和对抗菌药物敏感性状况,及其年代变化特点。方法采用荚膜肿胀试验鉴定6群、6A和6B型;采用multi-bead assay分型方法从6A型中鉴定6C型;用E试验法检测青霉素等8种抗菌药物对细菌的MIC。结果 1997—2007年分离到肺炎链球菌893株,从中鉴定出6群119株(13.3%),包括6A型71株(59.7%)、6B型39株(32.7%)和6C型9株(7.6%)。6群菌株对青霉素、头孢呋辛和红霉素的不敏感率分别从1997—2000年的3.4%、1.7%和86.2%上升到2005—2007年的29.4%、23.5%和100%,MIC90和最大MIC值也升高。6A、6B和6C型菌对青霉素的不敏感率分别为7.2%、24.3%和0。结论北京儿童医院呼吸道感染患儿分离的病原菌6群肺炎链球菌以6A型(59.7%)为主,存在新发现的6C型;6群肺炎链球菌对β内酰胺类抗生素和红霉素的耐药性在增加,6B型菌株抗生素耐药性较6A型、6C型强。Objective To investigate the serotypes and antimicrobial resistance of serogroup 6 Streptococcus pneumoniae （S.pneumoniae） isolated from children with upper respiratory infection in Beijing from 1997 to 2007. Methods The serogroup 6 and type 6A and 6B of the S.pneumoniae isolates were determined by the quellung reaction using antiserum. Serotype 6C was determined by the multi-bead assay. The minimum inhibitory concentration （MIC） was determined by E-test method for penicillin,amoxicillin-clavulanic acid,ceftriaxone,cefuroxime,erythromycin,imipenem,vancomycin and levofloxacin. Results A total of 893 S. pneumoniae strains were isolated from 1997 to 2007,and 119 （13.3%） strains were identified as serogroup 6. The number （proportion） of type 6A,6B and 6C were 71 （59.7%）,39 （32.7%） and 9 （7.6%）,respectively. The non-susceptibility rate to penicillin,cefuroxime and erythromycin increased from 3.4%,1.7% and 86.2% during 1997—2000 to 29.4%,23.5% and 100% during 2005—2007,respectively. The values of MIC 90 and the maximum value of MIC of the three antibiotics also increased. The non-susceptibility rate of type 6A,6B and 6C to penicillin was 7.2%,24.3% and 0,respectively. Conclusions Type 6A was the main type of serogroup 6 S. pneumoniae isolated from children in Beijing. The recently reported type 6C can be found,but less frequently than other types. The resistance of serogroup 6 S. pneumoniae to β-lactams and macrolide antibiotics is more common than before. Type 6B is more resistant than type 6A and 6C.

关 键 词：肺炎链球菌 分型 耐药性 抗生素 儿童 

分 类 号：R446.5[医药卫生—诊断学] R725.6[医药卫生—临床医学]