北京儿童医院2013—2017年住院儿童肺炎链球菌分离株的血清型分析  

Study on serotypes of Streptococcus pneumoniae isolated from hospitalized child in Beijing Children's Hospital(2013-2017)

作　　者：刘莹 董方[2] 史伟 刘钢[3] 钱素云[4] 徐保平[5] 王青 孟庆红 申昆玲[5] 姚开虎 LIU Ying, DONG Fang, SHI Wei, et al(Microbiology Laboratory of Beijing Pediatric Research Institute, Beijing Children＇ s Hospital, Capital Medical University, National Center for Children＇s Health, Beijing 100045, Chin)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院北京市儿科研究所微生物研究室,北京100045 [2]首都医科大学附属北京儿童医院检验科,北京100045 [3]首都医科大学附属北京儿童医院感染科 [4]首都医科大学附属北京儿童医院重症医学科 [5]首都医科大学附属北京儿童医院呼吸科

出　　处：《中华全科医学》2018年第4期514-517,625,共5页Chinese Journal of General Practice

基　　金：国家科技支撑计划课题(2013BAI09B11);国家自然科学基金(81371853)

摘　　要：目的分析分离自住院患儿的肺炎链球菌的血清型分布,评估肺炎链球菌结合疫苗(PCV)预防感染的价值。方法以2013年3月—2017年12月从北京儿童医院住院的751例患儿临床标本分离出的肺炎链球菌菌株为研究对象,采用荚膜肿胀试验对菌株进行血清分型。结果 5年共收集非重复病例肺炎链球菌751株,其中非侵袭性菌株684株,侵袭性菌株67株。非侵袭性菌株主要分离自呼吸道分泌物(52.3%)和支气管灌洗液(44.4%),侵袭性菌株主要来自血液(50.7%)、胸腔积液(25.4%)和脑脊液(23.9%)。751株菌株中常见血清型为19F(37.0%)、19A(14.2%)、23F(9.5%)、14(7.9%)、6A(7.7%)和6B型(5.2%),共占总血清型的81.5%。PCV10、PCV13和PPV23的覆盖率分别为61.5%、84.3%和82.6%。非侵袭性菌株常见血清型为19F(37.3%)、19A(13.5%)、23F(9.5%)、6A(8.0%)、14(7.0%)和6B(5.6%),PCV10和PCV13的覆盖率分别为60.8%和83.0%。侵袭性菌株常见血清型为19F(34.3%)、19A(22.4%)、14(16.4%)、23F(9.0%)、6A(4.5%)、9V(3.0%)和1型(3.0%),PCV10和PCV13的覆盖率分别为68.7%和95.5%。结论北京儿童医院住院患儿分离的肺炎链球菌以19F、19A、23F、14、6A和6B型常见,PCV13覆盖率超过80%,在侵袭性感染株中更高,推广接种PCV13能够预防绝大多数肺炎链球菌感染。Objective To investigate the situation of serotype distribution of Streptococcus pneumoniae （ S. pneumoniae） isolated from Chinese hospitalized children and to evaluate the value of pneumococcal conjugate vaccine in the prevention of S. pneumoniae infection. Methods S. pneumoniae strains isolated from clinical specimens of 751 children hospital- ized in Beijing Children＇s Hospital between March, 2013 and December, 2017 were studied. The serum type was detec- ted by capsule swelling experiment. Results A total of 751 isolates of S. pneumoniae were collected, including 684 non- invasive strains and 67 invasive strains. The non-invasive strains were mainly isolated from respiratory secretions （52.3%） and bronchoalveolar lavage fluid （44.4%）. The invasive strains were mainly isolated from blood （50.7 % ）, pleural effusion （ 25.4% ） and cerebrospinal fluid （ 23.9% ）. The common serotypes of the 751 strains were 19F （37.0%）, 19A （14.2%）, 23F （9.5%）, 14 （7.9%）, 6A （7.7%） and 6B （5.2%）, accounting for 81.5%. The coverage rates of PCV10, PCV13 and PPV23 were 61.5%, 84.3% and 82.6% , respectively. The most common sero- types of non-invasive strains were 19F （37.3%）, 19A （ 13.5% ）, 23F （9.5%）, 6A （8.0%）, 14 （7.0%） and 6B （5.6%）. The coverage rates of PCV10 and PCV13 were 60.8% and 83.0% , respectively. The most common serotypes of invasive strains were 19F （34.3%）, 19A （22.4%）, 14 （ 16.4% ）, 23F （9.0%）, 6A （4.5%）, 9V （3.0%） and 1 （3.0%）. The coverage rates of PCV10 and PCV13 were 68.7% and 95.5% , respectively. Conclusion Serotype 19F, 19A, 23F, 14, 6A and 6B, all of which were included in PCV13, were the common types among the pneumococcal strains isolated from hospitalized children in Beijing Children＇s Hospital. The coverage rate of PCV13 is more than 80% , and the coverage rate is higher in the invasive infection strains, indicating the promotion of PCV13 can prevent the overwhelming majority of S. pneumoniae infectio

关 键 词：肺炎链球菌 血清型 疫苗 儿童 

分 类 号：R378.12[医药卫生—病原生物学] R446.5[医药卫生—基础医学]