摘要
目的分析儿童感染肺炎链球菌的临床特征及其耐药特征。方法随机选择2015年1月至2018年4月于南京医科大学附属儿童医院门诊确诊感染肺炎链球菌的224例患儿临床资料。分析患儿年龄分布,肺炎链球菌感染季节分布、血清分型以及对抗菌药物耐药性等。结果1个月~1岁患儿肺炎链球菌感染发生率为56.25%(126/224),显著高于1~3岁(23.21%,52/224)和3~7岁患儿(20.54%、46/224),差异均有统计学意义(χ^2=51.045、60.398,P均<0.001);冬季患儿肺炎链球菌感染率(52.67%,118/224)显著高于春季(20.09%,45/224)、夏季(12.95%,29/224)和秋季(14.28%,32/224),差异有统计学意义(χ^2=51.392、80.200、74.126,P均<0.001)。2014年至2017年患儿肺炎链球菌感染率差异无统计学意义(χ^2=5.191,P=0.158)。224株肺炎链球菌共涉及11个血清型/群,主要分布于19F、19A、14型、9V、23F、6B、8型、7F、7A和其他等,另有11株未能分型。不同血清型肺炎链球菌对青霉素的耐药性不同,青霉素(脑膜炎)的不敏感率高达75.00%(52/68),显著高于青霉素(非脑膜炎)[56.41%(88/156)],差异有统计学意义(χ^2=69.142、P<0.001)。患儿所感染肺炎链球菌对红霉素、复方新诺明和克林霉素耐药率分别为84.82%(190/224)、78.13%(175/224)和75.89%(170/224);而对万古霉素和氯霉素敏感率分别为100.00%(224/224)、96.44%(216/224)。结论明确儿童感染肺炎链球菌好发年龄、季节、血清分布与耐药性差异,有利于指导临床合理应用抗菌药物。
Objective To investigate the clinical characteristics and drug resistance of children infected with Streptococcus pneumoniae.Methods The clinical data of 224 cases with Streptococcus pneumoniae infection were selected by random sampling from January 2015 to April 2018 in the Outpatient Department of Children’s Hospital Affiliated to Nanjing Medical University.The age distribution of children with Streptococcus pneumoniae infection,the seasonal distribution,serum types and the drug resistance to antibiotics of Streptococcus pneumoniae were analyzed,respectively.Results The incidence of Streptococcus pneumoniae infection among children aged 1 month to 1 year old was 56.25%(126/224),which was significantly higher than that of cases aged 1-3 years old(23.21%,52/224)and 3-7 years old(20.54%,46/224),both with significant differences(χ^2=51.045,60.398;both P<0.001).The rate of cases with Streptococcus pneumoniae infection in winter(52.67%,118/224)was significantly higher than that in spring(20.09%,45/224),summer(12.95%,29/224)and autumn(14.28%,32/224),with significant differences(χ^2=51.392,80.200,74.126;all P<0.001).There was no significant difference in the annual incidence of Streptococcus pneumoniae infection from 2014 to 2017(χ^2=5.191,P=0.158).The 224 Streptococcus pneumoniae strains involved 11 serotypes/groups,mainly distributed in 19 F,19 A,14,9 V,23 F,6 B,8,7 F,7 A and others,while 11 strains could not be classified.Different serotypes were resistant to penicillin,and the insensitivity rate of penicillin(meningitis)was 75.00%.Different serotypes had different resistance to penicillin,and the insensitivity rate of penicillin(meningitis)was 75.00%(52/68),which was significantly higher than that of penicillin(non-meningitis)[56.41%(88/156)],with significant difference(χ^2=69.142,P<0.001).The resistance rates of Streptococcus pneumoniae to erythromycin,compound norepinephrine and clindamycin were 84.82%(190/224),78.13%(175/224)and 75.89%(170/224),respectively.But the sensitivity rates to vancomycin and chloramphenicol were 100.00%(224/224)and 96.44%(216/224),respectively.Conclusions The clinical characteristics of age,season,serum distribution and drug resistance in children with Streptococcus pneumoniae infection were helpful to guide the clinical and rational application of the antibacterial drugs.
作者
韩菲
戴锦程
孙杭
谈华
刘雪梅
Han Fei;Dai Jincheng;Sun Hang;Tan Hua;Liu Xuemei(Department of Pathology,Children’s Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China;Department of Clinical Laboratory,Children’s Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2019年第5期357-361,共5页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
关键词
儿童
肺炎链球菌
临床特征
耐药性
敏感性
Children
Streptococcus pneumoniae
Serotype distribution
Drug resistance
Sensitivity
