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上海某儿童医院引起非侵袭性疾病的肺炎链球菌血清型分布及耐药性

Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae causing noninvasive diseases in a Children's Hospital, Shanghai.

作者信息

Pan Fen, Han Lizhong, Kong Jing, Wang Chun, Qin Huihong, Xiao Shuzhen, Zhu Junying, Zhang Hong

机构信息

Department of Clinical Laboratory, Children's Hospital of Shanghai, Shanghai Jiaotong University, Shanghai, China.

Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Braz J Infect Dis. 2015 Mar-Apr;19(2):141-5. doi: 10.1016/j.bjid.2014.08.010. Epub 2015 Jan 27.

Abstract

BACKGROUND

Streptococcus pneumoniae, which cause noninvasive pneumococcal diseases, severely impair children's health. This study analyzed serotype distribution and antimicrobial resistance of S. pneumoniae from January 2012 to December 2012 in a Children's Hospital, Shanghai.

METHODS

A total of 328 pneumococcal isolates were serotyped by multiplex sequential PCR and/or capsule-quellung reaction. The minimum inhibitory concentrations for 11 antimicrobial agents were determined by broth microdilution method.

RESULTS

Among 328 strains, 19F (36.3%), 19A (13.4%), 6A (11.9%), 23F (11.0%), 14 (5.8%), 6B (5.2%), and 15B/C (4.3%) were the most common serotypes. The coverage rates of 7-, 10-, and 13-valent conjugate vaccines (PCV7, PCV10, and PCV13) were 58.2%, 58.2%, and 84.1%, respectively. Out of the isolates, 26 (7.9%) strains were penicillin resistant. Most of the strains displayed high resistance rate to macrolides (98.5% to erythromycin, 97.9% to azithromycin, and 97.0% to clindamycin).

CONCLUSIONS

The potential coverage of PCV13 is higher than PCV7 and PCV10 because of the emergence of 19A and there should be long-term and systematic surveillance for non-vaccine serotypes.

摘要

背景

引起非侵袭性肺炎球菌疾病的肺炎链球菌严重损害儿童健康。本研究分析了2012年1月至2012年12月上海某儿童医院肺炎链球菌的血清型分布及耐药情况。

方法

采用多重序列PCR和/或荚膜肿胀反应对328株肺炎球菌进行血清型鉴定。采用肉汤微量稀释法测定11种抗菌药物的最低抑菌浓度。

结果

在328株菌株中,最常见的血清型为19F(36.3%)、19A(13.4%)、6A(11.9%)、23F(11.0%)、14(5.8%)、6B(5.2%)和15B/C(4.3%)。7价、10价和13价结合疫苗(PCV7、PCV10和PCV13)的覆盖率分别为58.2%、58.2%和84.1%。分离菌株中,26株(7.9%)对青霉素耐药。大多数菌株对大环内酯类药物耐药率较高(对红霉素耐药率为98.5%,对阿奇霉素耐药率为97.9%,对克林霉素耐药率为97.0%)。

结论

由于19A血清型的出现,PCV13的潜在覆盖率高于PCV7和PCV10,应对非疫苗血清型进行长期系统监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9ad/9425176/7d7a70b0310c/gr1.jpg

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