摘要
目的通过了解广东省深圳地区社区获得性肺炎患儿肺炎链球菌的血清群/型的分布,几种疫苗的覆盖情况及其对8种抗菌药物的耐药性,评估几种疫苗在本地区预防肺炎链球菌的价值,以及为临床合理应用抗生素提供参考。方法选择2006年2月—2007年2月广东省深圳地区社区获得性肺炎患儿分离的肺炎链球菌,进行血清分型,E试验法检测该菌对8种抗菌药物的耐药情况。结果 1011例患儿中分离出肺炎链球菌90株,分离率为8.9%。血清型分布以19F最常见(62.2%,56/90),其次为23F(15.6%,14/90)、6B(10.0%,9/90)、4(6.7%,6/90),7价疫苗覆盖率为94.4%。而9、10和11价疫苗所包含的血清型均未分离到。13价疫苗的覆盖率(97.8%)较7价疫苗无明显升高(χ2=1.34,P>0.05)。7价疫苗所含血清型的肺炎链球菌株中,青霉素耐药率为14.1%,所有分离的肺炎链球菌青霉素的耐药率为13.3%,对万古霉素100%敏感,氧氟沙星耐药率为0,阿莫西林的耐药率为2.2%。未出现耐亚胺培南菌株,但11.1%的菌株处于中介。对红霉素的耐药率高达98.9%,头孢呋辛的耐药率也达到64.4%,头孢曲松的耐药率为4.4%。结论广东省深圳地区社区获得性肺炎患儿肺炎链球菌的血清群/型的分布,以19F、23F、6B、4常见,7价疫苗覆盖率为94.4%。对万古霉素、左氧氟沙星、阿莫西林、亚胺培南敏感性高,青霉素、红霉素和头孢呋辛敏感率低。
Objective To investigate serotype/serogroup distribution of S. pneumoniae in children with community-acquired pneumonia in Shenzhen,understand possible vaccine coverage of the serotypes and the bacterial resistance to 8 antibiotics. Methods S. pneumoniae strains were isolated from the sputum,cerebrospinal fluid,blood and pleural effusion of children with community-acquired pneumonia in Shenzhen during February 2006 and February 2007. The isolates were serotyped by capsular swelling technique. Susceptibility to 8 antibiotics was determined by E-test. Results Ninety strains of S. pneumoniae were isolated from 1 011 specimens. The prevalence was 8.9%. Of these isolates,89 were from sputum,1 from pleural effusion. Serotype 19F was the most frequently isolated type （62.2%,56/90）,followed by 23F （15.6%,14/90）,6B （10.0%,9/90）,4 （6.7%,6/90）. These 4 serotypes accounted for 94.4% of all isolates. About 94.4% of these isolates were covered by the 7-valent pneumococcal conjugate vaccine （PCV7）. The additional serotypes contained in 9,10 and 11-valent pneumococcal conjugate vaccines were not identified. The coverage of 13-valent pneumococcal conjugate vaccine was 97.8%,showed no significant difference from that of PCV7 （χ 2=1.34,P0.05）. Of the serotypes in PCV7,14.1% were resistant to penicillin. About 13.3% of all S. pneumoniae isolates were resistant to penicillin. No resistant strain was found to vancomycin,levofloxacin or imipenem. About 98.9%,64.4% and 4.4% of the isolates were resistant to erythromycin,cefuroxime and ceftriaxone respectively. Conclusions The 19F,23F,6B and 4 serotypes are the most frequently isolated pneumococcal strains in children with community-acquired pneumonia in Shenzhen area. PCV7 can cover 94.4% of these S. pneumoniae strains. These S. pneumoniae strains are highly sensitive to vancomycin,levofloxacin,amoxicillin and imipenem,but relatively resistant to penicillin,erythromycin and cefuroxime.
出处
《中国感染与化疗杂志》
CAS
2010年第3期205-208,共4页
Chinese Journal of Infection and Chemotherapy
基金
广东省深圳市医学重点学科建设资助(2005C03)
惠氏制药有限公司(中国)的资助(0887X-101894)
关键词
社区获得性肺炎
肺炎链球菌
血清群/型
耐药性
community-acquired pneumonia
Streptococcus pneumoniae
serotype/serogroup
antibiotic resistance
