Cullotta Anna R, Kalter H D, Delgado Jose, Gilman Robert H, Facklam Richard R, Velapatino Billie, Coronel Jorge, Cabrera Lilia, Urbina M
Emory University Hospital. Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Diagn Lab Immunol. 2002 Nov;9(6):1328-31. doi: 10.1128/cdli.9.6.1328-1331.2002.
Streptococcus pneumoniae isolates were obtained from nasopharyngeal swabs taken from children living in a low socioeconomic area of Lima, Peru, to determine the rates of antimicrobial resistance and serotype distribution. A total of 146 nasopharyngeal isolates were collected from children from 3 to 38 months of age. Twenty-one clinical laboratory isolates from both sterile and nonsterile sites were obtained from a local hospital. Isolates with reduced susceptibilities to penicillin represented 15.1 and 42.9% of the nasopharyngeal and clinical isolates, respectively. For neither group of isolates did penicillin MICs exceed 1.5 micro g/ml, indicating only intermediate resistance. Thirty-two different serotypes were identified from the 146 nasopharyngeal isolates. The serotypes of the clinical isolates were represented among those 32 types. Isolates with reduced susceptibility to multiple antimicrobial agents were present in both settings. These findings indicate some of the highest rates of antimicrobial resistance in the region as well as a slightly different serotype distribution pattern from those of other South American countries. The 7-valent conjugate pneumococcal vaccines would only have a limited effect, providing coverage for about half of all isolates. Increasing rates of resistance in Peru necessitate an awareness of antimicrobial treatment practices and vaccination strategies.
从秘鲁利马一个社会经济地位较低地区的儿童鼻咽拭子中获取肺炎链球菌分离株,以确定抗菌药物耐药率和血清型分布情况。总共从3至38个月大的儿童中收集了146株鼻咽分离株。从当地一家医院获得了21株来自无菌和非无菌部位的临床实验室分离株。对青霉素敏感性降低的分离株分别占鼻咽分离株和临床分离株的15.1%和42.9%。两组分离株的青霉素最低抑菌浓度(MIC)均未超过1.5μg/ml,仅表明为中度耐药。从146株鼻咽分离株中鉴定出32种不同的血清型。临床分离株的血清型包含在这32种类型之中。在两种情况下均存在对多种抗菌药物敏感性降低的分离株。这些发现表明该地区的抗菌药物耐药率在某些方面是最高的,并且血清型分布模式与其他南美国家略有不同。7价结合肺炎球菌疫苗的效果有限,仅能覆盖约一半的分离株。秘鲁耐药率不断上升,这就需要对抗菌治疗方法和疫苗接种策略有所认识。