摘要
目的探讨小儿猩红热A组β型链球菌的流行病学特点及其对常见抗生素的耐药情况。方法选取2017年1月至2018年1月在浙江省海宁市人民医院就诊的患猩红热小儿147例为研究对象,取咽拭子标本进行病原体分离培养,分析菌株类别及emm基因类型,并检测8种常用抗生素的耐药性。结果①147例患儿的咽拭子标本中共分离出147株A组β型链球菌,其中婴儿占2.72%,幼儿占10.88%,学龄前儿童占45.58%,学龄初期儿童占38.10%,学龄晚期儿童占2.72%,学龄前及学龄初期儿童占比最高,为高发人群。农村发病率高于城镇;4-7月份为流行高峰期。②猩红热A组β型链球菌对青霉素、头孢曲松等药物敏感,但对克林霉素和克拉霉素不敏感。③在147株A组β型链球菌中共检出5种emm基因型,其中emm1型基因最常见,为53株(36.05%)。结论学龄前及学龄初期儿童易感染A组β型链球菌,青霉素和头孢曲松可作为首选药,但是不推荐克林霉素和克拉霉素。
Objective To investigate the epidemiological characteristics of Streptococcus pyogenes in children with scarlet fever and their resistance to common antibiotics. Methods 147 cases of scarlet fever, hospitalized in Haining People’s Hospital during the period from January to February 2018, were selected as subjects. Pharyngeal swab specimens were used to isolate and culture the pathogens, and then strain types and emm gene types were analyzed. Resistance to 8 common antibiotics was studied. Results 1) 147 strains of Streptococcus pyogenes were isolated from the pharyngeal swab specimens, of which those from the infants took up 2.72%, those from the babies took up 10.88%, those from the preschool age children took up 45.58%, those from early school age children took up 38.10%, and those from the late school age children took up 2.72%. The preschool and early school age children were the group with the highest risk for infection of scarlet fever. The infection rate of rural children was higher than that of the urban children and the peak season for the infection was from April to July. 2) Scarlet fever by group A of S. pyogenes, was sensitive to penicillin, ceftriaxone, etc. but not sensitive to clindamycin and clarithromycin. 3) Of 147 strain types of Streptococcus pyogenes, 5 emm1 genotypes had been detected, of which emm type 1 gene was the most common. There were 53 strains(36.05%). Conclusion Children of preschool and early school age are more susceptible to infection with Streptococcus pyogenes. Penicillin and ceftriaxone are preferred drugs, but clindamycin and clarithromycin are not recommended.
作者
杨忠浩
王菊芳
YANG Zhonghao;WANG Jufang(Haining People's Hospital,Zhejiang Haining 314400,China)
出处
《中国妇幼健康研究》
2020年第1期35-38,共4页
Chinese Journal of Woman and Child Health Research
关键词
猩红热
儿童
A组β型链球菌
抗药性
基因型
Scarlet fever
child
Streptococcus pyogenes
drug resistance
Genotype
