儿童重症肺炎链球菌肺炎的感染状况、耐药性及血清型研究  

Study on Infection Status,Drug Resistance and Serotype of Severe Streptococcus Pneumoniae Pneumonia in Children

作　　者：孔程祥 王飞玲[1] 李莉 金萍[1] 吴丽娟[1] 谢红波[1] KONG Chengxiang;WANG Feiling;LI Li(Shenzhen Bao’an Maternal and Child Health Hospital,Shenzhen 518106,China)

机构地区：[1]深圳市宝安区妇幼保健院

出　　处：《中外医学研究》2019年第20期50-52,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：深圳市宝安区社会公益项目(项目编号:2016CX255)

摘　　要：目的:分析儿童重症肺炎链球菌肺炎的感染状况、血清学分型及耐药现状,为预防和控制肺炎链球菌感染提供依据。方法:回顾性分析2013年6月-2018年6月笔者所在医院PICU收治的重症肺炎链球菌肺炎患儿的临床资料,进行病原菌培养及药敏试验,并采用多重PCR对肺炎链球菌血清型体系进行检测。结果:共分离出肺炎链球菌86株(28.86%),位居首位;对抗菌药物的耐药率总体呈上升趋势,对红霉素、克林霉素、四环素、复方新诺明均有较高的耐药性,多数肺炎链球菌对青霉素类、头孢类药物敏感,对万古霉素、利奈唑胺的耐药率为0,未发现对喹诺酮类药物耐药;血清学分型检测以19F(29.07%)、23F(15.12%)、6型(15.12%)和19A(11.63%)为主。结论:肺炎链球菌仍是本地区儿童重症肺炎的主要病原菌,耐药问题日益显著,应正确合理使用抗生素,有效提高儿童重症肺炎的救治成功率。Objective:To analyze the infection status,serological classification and drug resistance of severe Streptococcus pneumoniae infection in children,so as to provide evidence for the prevention and control of Streptococcus pneumoniae infection.Method:The clinical data of children with severe Streptococcus pneumoniae admitted to PICU from June 2013 to June 2018 were analyzed retrospectively.The pathogen culture and drug sensitivity test were carried out,and the serotype system of Streptococcus pneumoniae was detected by multiplex PCR.Result:A total of 86 strains(28.86%) of streptococcus pneumoniae was isolated,ranking the first.The drug resistance rate of antibiotics was on the rise,and erythromycin,clindamycin,tetracycline and SMZ were all highly resistant.Most streptococcus pneumoniae were sensitive to penicillin and cephalosporins,while vancomycin linezolid and quinolones had no resistance.Serotype was mainly composed of 19F(29.07%),23F(15.12%),type 6(15.12%),and 19A(11.63%).Conclusion:Streptococcus pneumoniae is still the main pathogen of severe pneumonia in children in our region,and drug resistance is becoming increasingly significant.Therefore,antibiotics should be used correctly and rationally to effectively improve the success rate of treatment for severe pneumonia in children.

关 键 词：儿童 重症肺炎 肺炎链球菌 耐药性 血清型 

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