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2011年至2013年在中国一家医院收集的肺炎链球菌分离株的血清型分布及抗生素耐药性

Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected at a Chinese hospital from 2011 to 2013.

作者信息

Huang Songyin, Liu Xiaoqiang, Lao Weisi, Zeng Suhua, Liang Huiqi, Zhong Rihui, Dai Xinlu, Wu Xiquan, Li Hongyu, Yao Yandan

机构信息

Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.

Department of Ophthalmic Surgery, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.

出版信息

BMC Infect Dis. 2015 Aug 5;15:312. doi: 10.1186/s12879-015-1042-5.

Abstract

BACKGROUND

Streptococcus pneumoniae infections are a major cause of global morbidity and mortality, and the emergence of antibiotic-resistant Streptococcus pneumoniae strains has been increasingly reported. This study provides up-to-date information on bacterial serotype distribution and drug resistance from S. pneumoniae clinical isolates that could guide prevention and treatment strategies for pneumococcal disease in China.

METHODS

A total of 94 S. pneumoniae isolates were collected from outpatients and inpatients at one Chinese hospital from 2011-2013. Drug susceptibility and resistance was determined by minimum inhibitory concentrations (MICs). Capsular serotypes were identified by the quellung reaction test and multiplex polymerase chain reaction.

RESULTS

Fifteen serotypes were identified among the 94 S. pneumoniae clinical isolates that were collected. Prevalent serotypes were 19F (42.6 %), 19A (8.5 %), 3 (8.5 %), and 6B (7.4 %). Potential immunization coverage rates for the 7-, 10- and 13-valent pneumococcal polysaccharide conjugate vaccines were 59.6, 62.6, and 79.6 %, respectively. Resistance rates to tetracycline, erythromycin, and trimethoprim/sulfamethoxazole were 91.2, 80.2 and 63.8 %, respectively. Resistance rates to penicillin, amoxicillin, ceftriaxone, and cefotaxime were 47.3, 34.1, 19.8, and 18.7 %, respectively. In almost all cases, antimicrobial resistance of the S. pneumoniae isolates in patients five years or younger was higher than isolates collected from patients aged 51 years or older.

CONCLUSION

Prevalent serotypes among the 94 S. pneumoniae clinical isolates were 19F, 19A, 3, and 6B. The 13-valent pneumococcal polysaccharide conjugate vaccine covered the majority of the serotypes identified in this sample. Drug resistance varied among different serotypes and age groups. Clinical precautions should be taken to avoid the development of multidrug resistance in this potential human pathogen.

摘要

背景

肺炎链球菌感染是全球发病和死亡的主要原因,且抗生素耐药性肺炎链球菌菌株的出现报道日益增多。本研究提供了肺炎链球菌临床分离株细菌血清型分布和耐药性的最新信息,可为中国肺炎球菌疾病的预防和治疗策略提供指导。

方法

2011年至2013年期间,从中国一家医院的门诊和住院患者中收集了94株肺炎链球菌分离株。通过最低抑菌浓度(MIC)测定药物敏感性和耐药性。通过荚膜肿胀反应试验和多重聚合酶链反应鉴定荚膜血清型。

结果

在收集的94株肺炎链球菌临床分离株中鉴定出15种血清型。流行血清型为19F(42.6%)、19A(8.5%)、3(8.5%)和6B(7.4%)。7价、10价和13价肺炎球菌多糖结合疫苗的潜在免疫覆盖率分别为59.6%、62.6%和79.6%。对四环素、红霉素和甲氧苄啶/磺胺甲恶唑的耐药率分别为91.2%、80.2%和63.8%。对青霉素、阿莫西林、头孢曲松和头孢噻肟的耐药率分别为47.3%、34.1%、19.8%和18.7%。几乎在所有情况下,5岁及以下患者的肺炎链球菌分离株的抗菌耐药性高于51岁及以上患者分离株。

结论

94株肺炎链球菌临床分离株中的流行血清型为19F、19A、3和6B。13价肺炎球菌多糖结合疫苗覆盖了本样本中鉴定出的大多数血清型。不同血清型和年龄组的耐药性有所不同。应采取临床预防措施,避免这种潜在人类病原体产生多重耐药性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87aa/4526307/09559093d52e/12879_2015_1042_Fig1_HTML.jpg

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