2010-2020年苏州某医院儿童侵袭性肺炎链球菌血清分型及耐药特征研究  

Serotype distribution and antimicrobial susceptibility of invasive streptococcus pneumoniae isolated from children in Suzhou from 2010 to 2020

作　　者：沈嘉铭 陶云珍[2] 刘长鹏 冯爽 王运中[2] 薛建[2] 张优仪 赵根明[1,3] 邵雪君 张涛[1,3] SHEN Jia-ming;TAO Yun-zhen;LIU Chang-peng;FENG Shuang;WANG Yun-zhong;XUE Jian;ZHANG You-yi;ZHAO Gen-ming;SHAO Xue-jun;ZHANG Tao(Department of Epidemiology,School of Public Health,Fudan University/Key Laboratory of Public Health Safety Ministry of Education,Shanghai 200032,China;Department of Clinical Laboratory,Soochow University Affiliated Children’s Hospital,Suzhou 215003,Jiangsu Province,China;Shanghai Institute of Infectious Disease and Biosecurity,Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室,上海200032 [2]苏州大学附属儿童医院检验科,苏州215003 [3]上海市重大传染病和生物安全研究院,上海200032

出　　处：《复旦学报（医学版）》2023年第6期829-835,共7页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金(81102166);苏州市民生科技关键技术应用研究项目(SS201867);苏州医工结合协同创新研究项目(SLC20904);上海市市级重大科技专项(ZD2021CY001)。

摘　　要：目的 了解苏州地区儿童侵袭性肺炎链球菌的血清型和耐药特征。方法 系统收集2010-2020年间苏州大学附属儿童医院分离的侵袭性肺炎链球菌菌株,采用Kirby-Bauer纸片扩散法或E-test法检测抗菌药物的敏感性,通过荚膜肿胀试验进行血清分型。结果 研究期间共分离到215株侵袭性肺炎链球菌,28.4%的菌株来自脑膜炎患儿。菌株对青霉素G的不敏感率为35.9%,13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine,PCV13)的血清型覆盖率为93.2%,其中最常见的血清型为6B、14、19F、19A和23F。近年来,头孢噻肟和复方新诺明的不敏感率有所下降,血清型6B、14的占比显著下降、而血清型19F、23F的占比则有所上升。结论 苏州地区儿童侵袭性肺炎链球菌菌株PCV13疫苗血清型覆盖率高,菌株对青霉素中度敏感,不同时间和不同疾病来源分离株的血清型和耐药性存在差异。Objective To investigate the serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolated from children in Suzhou.Methods The invasive Streptococcus pneumoniae isolates were systematically collected from Children’s Hospital of Soochow University between 2010 to 2020.The susceptibility of antibiotics was detected with Kirby-Bauer disk diffusion and E-test method,and the isolates were serotyped by Quellung reactions.Results A total of 215 invasive pneumococci isolates were collected during the study period,28.4%of which were from children with meningitis.The non-susceptibility rate to penicillin G was 35.9%.The coverage of the 13-valent pneumococcal conjugate vaccine(PCV13)was 93.2%,and the common serotypes were 6B,14,19F,19A and 23F.In recent years,the non-susceptibility rate of Cefotaxime and Trimethoprim-sulphamethoxazole has decreased,and the proportion of serotypes 6B and 14 has decreased significantly,while the proportion of serotypes 19F and 23F has increased significantly.Conclusion The coverage of PCV13 vaccine serotypes was high among the invasive isolates Streptococcus pneumoniae isolated from children in Suzhou,and the invasive pneumococci were moderately sensitive to penicillin.There were differences in serotypes and antimicrobial resistance between different times and different sources of disease.

关 键 词：侵袭性肺炎链球菌 血清型 抗菌敏感性 儿童 

分 类 号：R37[医药卫生—病原生物学]