摘要
目的 研究临床分离的侵袭性肺炎链球菌血清型分布、耐药性及分子流行病学特点,为抗生素的应用和免疫预防提供参考依据.方法 收集2005年1月至2008年8月全国15个地区148株来自血液、脑脊液等侵袭性感染部位的肺炎链球菌.采用琼脂稀释法测定青霉素等抗生素对148株肺炎链球菌的最低抑菌浓度（MIC）;采用简易棋盘式肺炎链球菌分型系统和荚膜肿胀实验进行血清分型;多位点序列分型（MIST）技术对53株19群菌株进行基因分型,了解其与国际流行株的关系.结果 血清分型共检出20个血清型/群,主要集中在19A、19F、3、23F、5、6、14和9血清型/群,共计105株,占70.9%,以19A（22.3%,33/148）、19F（16.9%,25/148）最常见,其次为3群（7.4%,11/148）和23F（6.8%,10/148）.7价疫苗（PCV7）在2岁以下儿童中的覆盖率为33.3%（12/36）.PCV7相关血清型肺炎链球菌对阿莫西林/克拉维酸、红霉素等耐药率均明显高于非疫苗相关血清型菌株（P〈0.05）.53株19群肺炎链球菌MIST分析共检出9种序列型（ST）,其中以ST320（28/53,52.8%）和ST271（12/53,22.6%）为主.结论 我国侵袭性肺炎链球菌血清分型以19A、19F、3和23F血清型为主.侵袭性肺炎链球菌耐药情况严重.
Objective To investigate the serotype distribution, antimicrobial resistance patterns and molecular epidemiology of Streptococcus pneumoniae （ 5. pneumoniae） isolated from invasive pneumococcal diseases in order to provide rationales for antibiotics application and immunity control of 5. pneumoniae. Methods A total of 148 isolates of invasive S. pneumoniae were collected from blood, cerebrospinal fluid and other sterile body fluids from 15 regions between January 2005 and August 2008 nationwide. Agar dilution method was used to determine the minimal inhibitory concentrations （MICs） of penicillin and other antibiotics against these isolates. Simplified chessboard system and capsule swelling reaction were used for serotyping of S. pneumoniae. Multilocus sequence typing （ MLST） was used to determine the genetic relationship of 53 strains of serogroup-19. Results Twenty serotypes/serogroups were identified in 148 strains. The prevalent serotypes （70. 9% ） were 19A, 19F, 3, 23F, 5, 6, 14 and 9 respectively. Serotypes 19A （22. 3% , 33/148） and 19F （16. 9% , 25/148） were the most frequent type observed. And serotypes 3 （7. 4% , 11/148） and 23F（6. 8% , 10/148） were less prevalent Of all 36 strains isolated from infants under 2 years old, 33. 3% （12/36） were covered by 7-valent pneumococcal conjugate vaccine （PCV7）. The resistant rates to amoxicillin/clavulanic acid, erythromycin and other antibiotics in PCV7-related pneumococcal strains were significantly higher than those in PCV7-unrelated group （P 〈 0. 05）. Fifty-three strains of serogroup-19 were genotyped by MLST and 9 sequence types （STs） identified. ST320 （52. 8% , 28/53） and ST271 （22.6% , 12/53） were the most frequent STs. Conclusions The major serotypes of invasive S. pneumoniae are 19A, 19F, 3 and 23F. Antimicrobial-resistant S. pneumoniae has become a serious issue of public health.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第22期1565-1570,共6页
National Medical Journal of China
关键词
链球菌
肺炎
血清分型
抗药性
微生物
多位点序列分型
侵袭性疾病
Streptococcus pneumoniae
Serotyping
Drug resistance,microbial
Multilocus sequence typing
Invasive diseases
