Wang Junrong, Liu Fenqin, Ao Peiran, Li Xianneng, Zheng Haixiao, Wu Di, Zhang Nina, Yu Junping, Yuan Junhui, Wu Xiuying
Department of Laboratory Medicine, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang Province, China.
Department of Gynecology, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang Province, China.
Lab Med. 2017 Feb;48(1):39-45. doi: 10.1093/labmed/lmw059. Epub 2016 Dec 29.
To analyze the serotype distribution and drug resistance of Streptococcus pneumoniae isolated from pediatric patients in a Chinese hospital.
From October 2011 to May 2014, we collected 284 isolates (including 217 noninvasive and 67 invasive strains). We tested the antimicrobial susceptibility of these specimens using the Epsilomer test and disk diffusion method, and the expression of macrolide resistant genes ermB and mefA by polymerase chain reaction.
The most common serotype for 217 noninvasive strains was 19F (31.3%). The coverage rates of the 7-, 10-, and 13-valent pneumococcal conjugate vaccines (PCV7, PCV10, and PCV13) were 53.9%, 53.9%, and 86.2%, respectively. For 67 invasive strains, the most common serotype was 23F (22.4%). The coverage rates of PCV7, PCV10, and PCV13 for invasive strains were 77.6%, 82.1%, and 91.0%, respectively. The susceptibility of strains isolated from nonmeningitis specimens to penicillin (PEN) was 97.2%. The rate of multidrug resistance in 284 isolates was 98.7%. All of these isolates were resistant to erythromycin (ERY) and had the ermB gene; 38.6% of those isolates had the mefA gene.
Compared with PCV7 and PCV10, the coverage rate of PCV13 was relatively higher for the S. pneumoniae isolates from pediatric patients. This finding suggests that PCV13 probably plays the strongest role in prevention of pneumococcal diseases and control of multidrug resistance. Because pneumococci were sensitive to PEN, this drug is still the preferred choice for clinical treatment of pediatric pneumococcal diseases.
分析某中国医院儿科患者分离出的肺炎链球菌的血清型分布及耐药情况。
2011年10月至2014年5月，我们收集了284株分离株（包括217株非侵袭性和67株侵袭性菌株）。我们使用Epsilomer试验和纸片扩散法检测这些标本的抗菌敏感性，并通过聚合酶链反应检测大环内酯耐药基因ermB和mefA的表达。
217株非侵袭性菌株中最常见的血清型是19F（31.3%）。7价、10价和13价肺炎球菌结合疫苗（PCV7、PCV10和PCV13）的覆盖率分别为53.9%、53.9%和86.2%。对于67株侵袭性菌株，最常见的血清型是23F（22.4%）。PCV7、PCV10和PCV13对侵袭性菌株的覆盖率分别为77.6%（77.6%）、82.1%和91.0%。从非脑膜炎标本中分离出的菌株对青霉素（PEN）敏感性为97.2%。284株分离株中的多重耐药率为98.7%。所有这些分离株均对红霉素（ERY）耐药且具有ermB基因；其中38.6%的分离株具有mefA基因。
与PCV7和PCV10相比，PCV13对儿科患者分离出的肺炎链球菌的覆盖率相对较高。这一发现表明PCV13可能在预防肺炎球菌疾病和控制多重耐药方面发挥最强作用。由于肺炎球菌对PEN敏感，该药物仍是儿科肺炎球菌疾病临床治疗的首选。
需注意，原文中部分覆盖率数据括号内重复，疑似有误，翻译时保留了原文表述。
