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[侵袭性肺炎球菌病患儿分离出的肺炎链球菌对肠外抗生素的敏感性]

[Susceptibility in parenteral antibiotics in Streptococcus pneumoniae isolated from children with invasive pneumococcal disease].

作者信息

Sakata Hiroshi

机构信息

Department of Pediatrics, Asahikawa Kosei Hospital.

出版信息

Kansenshogaku Zasshi. 2013 Jan;87(1):1-5. doi: 10.11150/kansenshogakuzasshi.87.1.

Abstract

Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of commonly used clinical antimicrobial drugs were examined for 76 strains of Streptococcus pneumoniae isolated between 2006 and 2011 from pediatric patients with invasive pneumococcal infection. Patients from whom bacterial strains were isolated ranged from 4 months to 6 years old and included 50 infants (65.8%) 1 year old and 10 (13.2%) less than 1 year old, i.e., 79.1% of all patients studied. In diagnosis, 38 (50.0%) had occult bacteremia, 34 (44.7%) pneumonia, 3 (3.9%) meningitis, and 1 (1.3%) sepsis. Infections in all but one case who died of sepsis were treated without sequelae. The most frequent capsular serotype among isolates was 6B (20 strains, 26.3%), followed by 19 F (13 strains, 17.1%) and 14 (9 strains, 11.8%). Serotypes for 55 strains (72.4%) corresponded to those contained in heptavalent pneumococcal conjugate vaccine. In classification by resistance based on mutations in penicillin-binding protein genes, 32 were penicillin-resistant S. pneumoniae (42.1%), 35 penicillin intermediate-resistant S. pneumoniae (46.1%), and 11 penicillin-susceptible S. pneumoniae (11.8%). MIC90/MBC90 of drugs were as follows: ampicillin 4/4 microg/mL, cefotaxime 0.5/0.5 microg/mL, ceftriaxone 1/2 microg/ mL, panipenem 0.125/0.125 microg/mL, meropenem 0.5/0.5 microg/mL, and doripenem 0.25/0.25 microg/mL.

摘要

对2006年至2011年间从患有侵袭性肺炎球菌感染的儿科患者中分离出的76株肺炎链球菌,检测了常用临床抗菌药物的最低抑菌浓度(MIC)和最低杀菌浓度(MBC)。分离出细菌菌株的患者年龄范围为4个月至6岁,其中包括50名1岁以下婴儿(65.8%)和10名1岁以下婴儿(13.2%),即占所有研究患者的79.1%。在诊断方面,38例(50.0%)患有隐匿性菌血症,34例(44.7%)患有肺炎,3例(3.9%)患有脑膜炎,1例(1.3%)患有败血症。除1例死于败血症的病例外,所有感染均得到治疗且无后遗症。分离株中最常见的荚膜血清型为6B(20株,26.3%),其次是19F(13株,17.1%)和14(9株,11.8%)。55株(72.4%)的血清型与七价肺炎球菌结合疫苗中所含的血清型相对应。根据青霉素结合蛋白基因突变进行的耐药分类中,32株为青霉素耐药肺炎链球菌(42.1%),35株为青霉素中介耐药肺炎链球菌(46.1%),11株为青霉素敏感肺炎链球菌(11.8%)。药物的MIC90/MBC90如下:氨苄西林4/4微克/毫升,头孢噻肟0.5/0.5微克/毫升,头孢曲松1/2微克/毫升,帕尼培南0.125/0.125微克/毫升,美罗培南0.5/0.5微克/毫升,多利培南0.25/0.25微克/毫升。

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