78株儿童侵袭性肺炎链球菌分子流行病学调查  

Investigation on molecular epidemiology of 78 children with invasive Streptococcus pneumoniae

作　　者：吴鹏[1] 周凯[1] 胡静[1] WU Peng;ZHOU Kai;HU Jing(Children's Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210008,China)

机构地区：[1]南京医科大学附属儿童医院

出　　处：《中国消毒学杂志》2018年第12期912-915,共4页Chinese Journal of Disinfection

基　　金：南京市科技发展计划项目(201605048);南京医科大学科技发展基金(2016NJMU104)

摘　　要：目的了解南京地区小儿侵袭性肺炎链球菌的分子特征和对常用抗菌药物的耐药率。方法收集2009年1月-2016年12月来自儿童侵袭性肺炎链球菌病患者血液、脑脊液和胸腔积液的78株肺炎链球菌。用K-B纸片法和E-试验法测定其耐药率; PCR和肺炎链球菌荚膜型血清凝集法确定血清型;脉冲场凝胶电泳法分析各血清型菌株的基因组特征;多位点序列分型技术确定序列分型; PCR和凝胶电泳法检测主要的毒力基因。结果肺炎链球菌主要血清型及构成比为19F(20. 51%)、19A(17. 95%)、14(15. 38%)、6B(14. 11%)和23F(11. 54%);对青霉素不敏感的IPD菌株为69. 23%;共检出16种序列分型,毒力基因lyt A、pav A、ply、psa A、spx B在各菌株中均为阳性。结论南京地区侵袭性肺炎链球菌血清型主要为19F、19A、14、6B和23F。儿童肺炎链球菌青霉素耐药性有上升趋势。序列分型表现具有多样性,流行序列分型、特定的血清型与抗生素耐药明显相关。Objective To study the molecular characteristics of infantile invasive Streptococcus pneumoniae in Nanjing and the resistance rate to commonly used antibiotics. Methods Seventy-eight strains of Streptococcus pneumoniae from blood,cerebrospinal fluid and pleural effusion of children with invasive streptococcal pneumonia were collected from January 2009 to December 2016. The drug resistance rate was determined by K-B disk method and E-test. PCR and Streptococcus pneumoniae capsular type serum agglutination were used to determine serotype. The genomic characteristics of serotypes were analyzed by pulsed field gel electrophoresis,and the sequence typing was determined by multilocus sequence typing.PCR and gel electrophoresis were used to detect the major virulence genes. Results The main serotypes and constituent ratios of Streptococcus pneumoniae were 19 F( 20. 51%),19 A( 17. 95%),14( 15. 38%),6 B( 14. 11%) and 23 F( 11. 54%). The penicillin-insensitive IPD strains were 69. 23%. A total of 16 genotypes were detected,and the virulence genes lyt A、pav A、ply、psa A and spx B were all positive in each strain. Conclusions The serotypes of IPD in Nanjing are mainly 19 F,19 A,14,6 B and 23 F. The penicillin resistance of Streptococcus pneumoniae in children is on the rise. Sequence typing shows diversity. Epidemic sequence typing and specific serotypes are significantly related to antibiotic resistance.

关 键 词：肺炎链球菌 侵袭性肺炎链球菌病 感染控制 毒力基因 

分 类 号：R446.5[医药卫生—诊断学]