住院患儿肺炎链球菌血清型与其耐药性的相关性分析  

Correlation Analysis of Serotype and Drug Resistance of Streptococcus Pneumoniae in Hospitalized Children

作　　者：赵恩丽 方盼盼[2] ZHAO En-li;FANG Pan-pan(Ruyang Hospital of Traditional Chinese Medicine,Ruyang He'nan 471200,China;Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]汝阳县中医院,河南汝阳471200 [2]郑州大学附属儿童医院,郑州450000

出　　处：《抗感染药学》2022年第1期26-29,共4页Anti-infection Pharmacy

基　　金：河南省医学科技攻关项目(项目编号:2018020677)。

摘　　要：目的:探究住院患儿肺炎链球菌(Streptococcus pneumoniae,SP)血清型及其对抗菌药物耐药情况。方法:选取医院2019年10月—2021年3月收治的SP患儿116例病历资料中分离出的SP菌株作为研究对象,统计患儿入院后采集的咽喉部痰液标本中SP菌株培养和鉴定结果,分析SP血清分型及其对常用抗菌药物耐药特点。结果:116株SP分离菌株中,血清型分型检出116株,其中血清型分布TOP 5分别为19F、6A、14、19A和23F;23价多糖疫苗覆盖血清型疫苗PCV 23(1~5 B、6B、7F、8N、9N、9V、10A、11A、12F、14B、15B、17F、18C、19A、19F、20F、22F、23F、33F)菌株覆盖率可达到67.24%,13价SP-PCV13(1A、3~5 A、6A、6B、7F、9V、14C、18C、19A、19F和23F)覆盖率为5.17%;药敏试验结果发现116株SP分离菌株对敏感性TOP 5药物为青霉素、头孢曲松、万古霉素、左氧氟沙星和利奈唑胺,其对红霉素和阿奇霉素的耐药率分别为98.28%、96.55%;PCV13覆盖与非PCV13覆菌株对比,其对头孢呋辛、红霉素、阿奇霉素的不敏感率(中介+耐药)间存在统计学差异(P<0.05);116株SP分离菌株中,其中19F、6A、14、19A、23F血清型菌株对红霉素及阿奇霉素不敏感型明显高于其他血清型菌株,而19F对于红霉素和阿奇霉素不敏感度率均达100.00%。结论:住院患儿SP常见血清型为19F、6A、14、19A和23F,其中PCV13疫苗接种后可达较高覆盖率,且PCV13覆盖株对红霉素和阿奇霉素不敏感率较高,临床治疗用药应尽可能规避红霉素和阿奇霉素。Objective:To explore the serotype distribution and drug resistance of Streptococcus pneumoniae(SP)in hospitalized children.Methods:SP strains isolated from 116 children with SP admitted to the hospital from October2019 to March 2021 were selected as the research objects,and the culture and identification results of SP strains in the sputum samples of the throat of the children collected after admission were counted.SP serotype and resistance to common antibacterials were analyzed.Results:Serotypes of 116 SP isolates were detected,of which the TOP 5 serotypes were 19F,6A,14,19A and 23F.The coverage rate of serotype vaccine PCV 23(1 to 5 B,6B,7F,8N,9N,9V,10A,11A,12F,14B,15B,17F,18C,19A,19F,20F,22F,23F,33F)was 67.24%.The coverage rate of SP-PCV13(1A,3 to 5 A,6A,6B,7F,9V,14C,18C,19A,19F and 23F)was 5.17%.The results of drug sensitivity test showed that the TOP 5 sensitive drugs of 116 SP isolates were penicillin,ceftriaxone,vancomycin,levofloxacin and linezolid,and their drug resistance rates to erythromycin and azithromycin were 98.28%and 96.55%,respectively.Compared with non-PCV13-covered strains,there was statistical difference in the insensitive rate(intermediate and drug resistance)to cefuroxime,erythromycin and azithromycin(P<0.05).Among 116 SP isolates,serotypes 19F,6A,14,19A and 23F were significantly more sensitive to erythromycin and azithromycin than other serotypes,and the insensitivity rates of 19F to erythromycin and azithromycin were 100.00%.Conclusion:The common serotypes of SP in hospitalized children are 19F,6A,14,19A and 23F,among which the coverage rate of PCV13 vaccine is higher.The covered strain of PCV13 is highly insensitive to erythromycin and azithromycin,so erythromycin and azithromycin should be avoided as much as possible in clinical treatment.

关 键 词：住院患儿 肺炎链球菌 血清型分布 抗菌药物 耐药特点 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]