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马来西亚肺炎链球菌血清型分布及药敏情况:四年(2014-2017 年)侵袭性儿科分离株研究。

Pneumococcal serotype distribution and antibiotic susceptibility in Malaysia: A four-year study (2014-2017) on invasive paediatric isolates.

机构信息

Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.

Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.

出版信息

Int J Infect Dis. 2019 Mar;80:129-133. doi: 10.1016/j.ijid.2018.12.009. Epub 2018 Dec 17.

Abstract

OBJECTIVE

This study was performed to analyze the serotype distribution of Streptococcus pneumoniae causing invasive pneumococcal disease (IPD) in children aged 5 years and under in Malaysia and to assess the antimicrobial resistance.

METHODS

From 2014 to 2017, a total of 245 invasive S. pneumoniae isolates from children ≤5 years of age were received from hospitals all around Malaysia. All isolates were identified and subjected to serotyping and antimicrobial susceptibility testing.

RESULTS

Of the 245 isolates, 117 (48.0%) were from children aged <1year, 46 (19.05%) were from children aged 1-2 years, and 82 (33.0%) were from children aged 2-5 years. The most common serotypes were 14 (26.9%), 6B (19.6%), 19A (11.8%), 6A (10.6%), and 19F (6.9%) and vaccine coverage was 88.2% for PCV13, 64.1% for PCV10, and 63.3% for PCV7. Resistance to penicillin was 0.2% for non-meningitis cases and 22.2% for meningitis cases; erythromycin resistance was reported in 42.9%, co-trimoxazole in 35.9%, and tetracycline in 42.9%.

CONCLUSIONS

Serotypes 14, 6B, 19A, 6A, and 19F were the most common serotypes isolated from children with IPD in Malaysia during this pre-vaccination era. The lack of reports on the serotype distribution has limited action for the implementation of PCV in the national immunization programme (NIP). The information from this study may benefit future policies for the introduction of PCV in the Malaysian NIP and ultimately may reduce the morbidity and mortality among children in Malaysia.

摘要

目的

本研究旨在分析马来西亚 5 岁以下儿童侵袭性肺炎球菌病(IPD)中导致疾病的肺炎链球菌血清型分布,并评估其抗菌药物耐药性。

方法

2014 年至 2017 年,从马来西亚各地医院共收到 245 株侵袭性肺炎链球菌分离株。所有分离株均经过鉴定,并进行血清分型和抗菌药物敏感性试验。

结果

245 株分离株中,117 株(48.0%)来自<1 岁的儿童,46 株(19.05%)来自 1-2 岁的儿童,82 株(33.0%)来自 2-5 岁的儿童。最常见的血清型为 14 型(26.9%)、6B 型(19.6%)、19A 型(11.8%)、6A 型(10.6%)和 19F 型(6.9%),PCV13 疫苗覆盖率为 88.2%,PCV10 为 64.1%,PCV7 为 63.3%。非脑膜炎病例对青霉素的耐药率为 0.2%,脑膜炎病例为 22.2%;红霉素耐药率为 42.9%,复方磺胺甲噁唑耐药率为 35.9%,四环素耐药率为 42.9%。

结论

在本疫苗接种前时代,血清型 14、6B、19A、6A 和 19F 是马来西亚儿童 IPD 中最常见的分离血清型。缺乏有关血清型分布的报告限制了国家免疫规划(NIP)中 PCV 实施的行动。本研究的信息可能有助于未来在马来西亚 NIP 中引入 PCV 的政策,并最终可能降低马来西亚儿童的发病率和死亡率。

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