衢州市单中心儿童肺炎链球菌感染流行及血清型分布特征研究  

Clinical characteristics and serotype distribution of Streptococcus pneumoniae isolated from children in Quzhou city

作　　者：杨云飞 邱玉萍 程颖[1] 李梦萍 朱扬帆 王燕飞[2] 刘林 陆军[1] YANG Yunfei;QIU Yuping;CHENG Ying;LI Mengping;ZHU Yangfan;WANG Yanfei;LIU Lin;LU Jun(Department of Clinical Laboratory,Quzhou People's Hospital(the Quzhou Affiliated Hospital of Wenzhou Medical University),Quzhou 324000,China;不详)

机构地区：[1]衢州市人民医院(温州医科大学附属衢州医院)检验科,324000 [2]浙江大学医学院附属邵逸夫医院感染科 [3]杭州医学院基础医学与法医学院

出　　处：《浙江医学》2024年第3期286-290,共5页Zhejiang Medical Journal

基　　金：衢州市科技攻关项目(2022K60)。

摘　　要：目的探讨衢州市儿童肺炎链球菌感染流行及血清型分布特征,为指导该地区的疫苗应用和研发提供依据。方法收集2020年1月至2022年6月衢州市人民医院肺炎链球菌感染患儿的临床资料及不同来源标本中分离的肺炎链球菌,进行系列菌株鉴定实验,并通过乳胶凝集试验、荚膜肿胀试验对所有菌株进行血清型鉴定,分析相关感染性疾病和血清型分布的流行特征。结果共收集到107株肺炎链球菌,除2株不能明确分型外共鉴定出21种血清型,排名前5位的血清型为19F、6B、14、19A和3。肺炎链球菌多糖结合疫苗(PCV)7、PCV13和PCV20的血清型覆盖率分别为56.1%(60/107)、71.0%(76/107)、78.5%(84/107)。肺炎链球菌引起儿童支气管肺炎是主要感染类型,不同PCV覆盖血清型肺炎链球菌引起支气管肺炎病例数的比较表明,PCV7覆盖血清型与非PCV7血清型无明显差异;但PCV13(P=0.008)和PCV20(P=0.002)覆盖血清型明显高于非该类疫苗覆盖血清型引起肺炎病例数。结论引起衢州市儿童肺炎链球菌疾病的主要流行血清型为19F、6B、14、19A和3,其中支气管肺炎为最主要感染类型;PCV13和PCV20对该地区儿童感染肺炎链球菌支气管肺炎有保护力,建立肺炎球菌疾病发病状况的监测系统,针对肺炎链球菌血清型分布和感染性疾病进行长期流行病学监测是非常必要的。Objective To investigate the clinical characteristics and serotype distribution of Streptococcus pneumoniae among children in Quzhou city.Methods Streptococcus pneumoniae strains were isolated from specimens of children under 16 years old in Quzhou People's Hospital from January 2020 to June 2022.Species identification was conducted with optochin and TOFMS tests,and serotyping was carried out through latex agglutination test and capsule swelling test.The distribution of serotypes and the epidemiological characteristics of related infectious diseases were analyzed.Results A total of 107 pneumococcal strains were collected,and 21 serotypes were identified with the top five serotypes of 19F,6B,14,19A,and 3.The serotype coverage rates of the pneumococcal polysaccharide conjugate vaccine(PCV)7,PCV13,and PCV20 were 56.1%(60/107),71.0%(76/107),and 78.5%(84/107),respectively.Bronchopneumonia was the main type of infection caused Streptococcus pneumoniae among children in this study.The chi-squared analysis of bronchopneumonia cases showed no significant difference between coverage of PCV7 and non-PCV7 serotypes,but the coverage of PCV13(P=0.008)and PCV20(P=0.002)serotypes was significantly higher than of non-vaccine covered serotypes.Conclusion The main serotypes of Streptococcus pneumoniae causing pneumococcal disease among children in the Quzhou city are 19F,6B,14,19A,and 3;and bronchopneumonia is the most common type of infection.Vaccines PCV13 and PCV20 provide significant protection against Streptococcus pneumoniae bronchopneumonia in children in this region.

关 键 词：肺炎链球菌 血清型 多糖结合疫苗 儿童 

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