Ilki Arzu, Akbenlioğlu Cengiz, Yağci Ayşegül, Söyletir Güner, Bakir Mustafa
Marmara Universitesi Tip Fakültesi, Mikrobiyoloji Anabilim Dali, Haydarpaşa, Istanbul.
Mikrobiyol Bul. 2004 Jan-Apr;38(1-2):1-7.
Nasopharyngeal swab specimens from 324 children with respiratory tract infections were evaluated to detect the rate of Streptococcus pneumoniae colonisation. S. pneumoniae was detected in 92 (28%) of the subjects. Forty three (46.7%) of the isolates were serotyped by the capsular swelling tests. The most common serotypes were 19F, 6B, 3 and 23F. The 7, 9 and 11 valent conjugate pneumococcal vaccines covered 35.8%, 40% and 46.7% of all the S. pneumoniae isolates, respectively. Thirty two (34.8%) isolates exhibited penicillin MIC values between 0.1 and 1 microg/ml, only 1 isolate had MIC > or = 2 microg/ml. Penicillin resistant pneumococcal colonisation was most frequently detected in children with viral upper respiratory tract infections (12.5%). Resistance rates of trimetoprim-sulfamethoxazole, erythromycin, chloramphenicol, clindamycin, ceftriaxone, rifampin were 31.5%, 9.8%, 6.5%, 4.3%, 1%, 0%, respectively. Being a children of a family with low income was the only risk factor for colonisation with S. pneumoniae, whereas having a sibling attending to a day care center, antibiotic use in the last three months and use of more than one antibiotic were significant risk factors for colonisation with penicillin resistant S. pneumoniae (p < 0.05).
对324名患有呼吸道感染的儿童的鼻咽拭子标本进行评估,以检测肺炎链球菌定植率。在92名(28%)受试者中检测到肺炎链球菌。通过荚膜肿胀试验对43株(46.7%)分离株进行了血清分型。最常见的血清型为19F、6B、3和23F。7价、9价和11价肺炎球菌结合疫苗分别覆盖了所有肺炎链球菌分离株的35.8%、40%和46.7%。32株(34.8%)分离株的青霉素MIC值在0.1至1微克/毫升之间,只有1株MIC≥2微克/毫升。青霉素耐药肺炎链球菌定植最常见于患有病毒性上呼吸道感染的儿童(12.5%)。甲氧苄啶-磺胺甲恶唑、红霉素、氯霉素、克林霉素、头孢曲松、利福平的耐药率分别为31.5%、9.8%、6.5%、4.3%、1%、0%。家庭收入低是肺炎链球菌定植的唯一危险因素,而有兄弟姐妹在日托中心、过去三个月使用抗生素以及使用一种以上抗生素是青霉素耐药肺炎链球菌定植的显著危险因素(p<0.05)。