Iimura T, Amano Y, Matsue T, Onogawa T, Endo M, Okuno R, Kashiwagi Y, Matsuki K
Itabashichuo General Hospital.
Kansenshogaku Zasshi. 2001 Apr;75(4):314-25. doi: 10.11150/kansenshogakuzasshi1970.75.314.
During the 20-year period between 1979-1998, a total of 4,176 strains of hemolytic streptococci have been isolated from 20,118 healthy primary school children and little children in Tokyo Metropolitan (Tokubetsuku, Tama and Tosho). Culture of throat swabs every November and the following February during the 20-year period were made and serological grouping and typing for isolates were done by T agglutination method. The results were as follows. 1) Serological group of hemolytic streptococci isolated from children were 3,188 strains (76.3%) for isolates of group A out of total strains of 4,176, 569 strains (13.6%) for isolates group B, 63 strains (1.5%) for isolates of group C and 356 strains (8.5%) for isolates of group G. 2) The most dominant was T12 during 1979-1998, and other relatively frequent serotypes were T28, T1, T4, T6 in that order. These ranks of and the main epidemic serotypes showed a similar trend in the 3 areas. 3) The isolation rates of group A streptococci were 15.9% in Tokubetsuku, 17.1% in Tama and 14.9% in Tosho. The average of 3 areas were 15.8%. 4) The epidemic cases seemed to be caused by group A streptococci were 20 cases, their isolated serotype were 7 cases by T28, 5 cases by T12, 4 cases by T6, 2 cases by T4, each 1 case by T1 and T25. 5) A total of 2,927 strains of group A streptococci were examined for drug sensitivity. All strains were sensitive to beta-lactam group of antibiotics (benzylpenicillin and cephaloridine). Resistant (MIC > or = 25 micrograms/ml) to TC, CP and EM etc. were 740 strains (25.3%) in this study. The incidence of resistant strains were to TC 493 strains (66.6%) out of 740 strains, 81 strains (10.9%) for TC.CP, 72 strains (9.7%) for EM and 66 strains (8.9%) for TC.CP.EM.OL.LCM. TC resistant strains have not varied much through the whole period, but CP and EM resistant strains were very variable by year. Many resistant strains to TC were T4, to EM and multiple drug resistant were T12. 6) The rates of isolates of the same type of group A streptococci in school child individual during for the tests taken twice a year were 12.3%, indicating group A streptococci, according to the duration of the carrier state, seems to be a short period.
在1979年至1998年的20年间，从东京都（特别区、多摩和东商）的20118名健康小学生和幼儿中总共分离出4176株溶血性链球菌。在这20年期间，每年11月和次年2月进行咽拭子培养，并通过T凝集法对分离株进行血清学分群和分型。结果如下：1）从儿童中分离出的溶血性链球菌血清群中，A群分离株有3188株（占总菌株数4176株的76.3%），B群分离株569株（13.6%），C群分离株63株（1.5%），G群分离株356株（8.5%）。2）1979年至1998年期间最主要的是T12，其他相对常见的血清型依次为T28、T1、T4、T6。这3个地区这些血清型的排名和主要流行血清型呈现相似趋势。3）A群链球菌的分离率在特别区为15.9%，在多摩为17.1%，在东商为14.9%。3个地区的平均值为15.8%。4）疑似由A群链球菌引起的流行病例有20例，其分离的血清型为：T28型7例，T12型5例，T6型4例，T4型2例，T1型和T25型各1例。5）总共对2927株A群链球菌进行了药敏试验。所有菌株对β-内酰胺类抗生素（苄青霉素和头孢菌素）敏感。在本研究中，对四环素（TC）、氯洁霉素（CP）和红霉素（EM）等耐药（最低抑菌浓度≥25微克/毫升）的菌株有740株（25.3%）。耐药菌株中对TC耐药的有493株（占740株的66.6%），对TC.CP耐药的有81株（10.9%），对EM耐药的有72株（9.7%），对TC.CP.EM.OL.LCM耐药的有66株（8.9%）。对TC耐药的菌株在整个时期变化不大，但对CP和EM耐药的菌株逐年变化很大。对TC耐药的许多菌株是T4型，对EM和多重耐药的是T12型。6）在每年进行两次检测的学童个体中，A群链球菌同一血清型的分离率为12.3%，这表明根据带菌状态的持续时间，A群链球菌似乎处于短时期带菌。
