儿童侵袭性无乳链球菌血清型和耐药性分析  

Serotypes and drug resistance of invasive Streptococcus agalactiae in children

作　　者：陈寰 董方[2] 吕志勇[2] 甄景慧[2] 陈梅 苏建荣[1] CHEN Huan;DONG Fang;LÜZhiyong;ZHEN Jinghui;CHEN Mei;SU Jianrong(Center of Clinical Laboratory,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Center of Clinical Laboratory,Beijing Children's Hospital,Capital Medical University,National Center of Children's Health,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京友谊医院临床检验中心,北京100050 [2]国家儿童医学中心首都医科大学附属北京儿童医院检验中心,北京100045

出　　处：《检验医学》2024年第3期260-264,共5页Laboratory Medicine

摘　　要：目的分析儿童侵袭性无乳链球菌(B组链球菌,GBS)血清型和耐药性,为减少GBS感染和临床合理用药提供参考。方法收集2012年1月—2018年12月首都医科大学附属北京儿童医院分离自139例患儿无菌部位临床样本的GBS,进行血清分型和体外药物敏感性试验。结果139例患儿以新生儿为主(61.2%),其次为婴儿期患儿(38.8%)。共分离出185株侵袭性GBS,其中46.0%(64/139)分离自血液样本,20.9%(29/139)分离自脑脊液样本,33.1%(46/139)同时分离自血液和脑脊液样本。共检出5种血清型,以Ⅲ型检出率最高,占54.6%(76/139),以下依次为Ⅰb型(28.1%,39/139)、Ⅰa型(12.9%,18/139)、Ⅱ型和Ⅴ型(2.2%,3/139)。139株GBS对红霉素的耐药率最高(89.9%),其次为克林霉素(74.1%),对左氧氟沙星的耐药率为31.7%。未检测出对青霉素、头孢曲松、头孢吡肟、利奈唑胺、万古霉素不敏感的菌株。不同血清型GBS耐药性有一定差异。结论GBS引起的儿童侵袭性感染主要为血流感染和脑膜炎,掌握其血清型和耐药特征,对儿童临床感染的预防和治疗具有重要意义。Objective To investigate the serotypes and drug resistance causing invasive Streptococcus agalactiae(Group B Streptococcus,GBS)infection in children,and to provide a reference for clinical reduction of GBS infection and rational drug treatment.Methods GBS was isolated from sterile site specimens in Beijing Friendship Hospital of Capital Medical University from January 2012 to December 2018,and serotyping and in vitro drug susceptibility test were performed.Results Totally,139 cases were neonates(61.2%),followed by infants(38.8%).A total of 185 isolates of invasive GBS were isolated,of which 46.0%(64/139)were isolated from blood specimens,20.9%(29/139)were isolated from cerebrospinal fluid specimens,and 33.1%(46/139)were isolated from both blood and cerebrospinal fluid specimens.A total of 5 serotypes were isolated,of which typeⅢhad the highest determination rate(54.6%,76/139),followed by typeⅠb(28.1%,39/139),typeⅠa(12.9%,18/139),typeⅡand typeⅤ(2.2%,3/139,respectively).The drug resistance rate of 139 isolates of GBS to erythromycin was the highest(89.9%),followed by clindamycin(74.1%)and levofloxacin(31.7%).No isolates insensitive to penicillin,ceftriaxone,cefepime,linezolid and vancomycin were determined.There were some differences in drug resistance among different serotypes of GBS.Conclusions Invasive GBS infection in children can cause bloodstream infection and meningitis,and serotyping and drug susceptibility test are important for the prevention and treatment of pediatric clinical infections.

关 键 词：无乳链球菌 儿童 侵袭性感染 血清型 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]