Melander E, Ekdahl K, Hansson H B, Kamme C, Laurell M, Nilsson P, Persson K, Söderström M, Mölstad S
Department of Community Medicine, Lund University, Malmö, Sweden.
Microb Drug Resist. 1998 Spring;4(1):71-8. doi: 10.1089/mdr.1998.4.71.
As part of an intervention project, all patients in Malmöhus county with a culture positive for penicillin-resistant pneumococci, MIC > or =0.5 mg/L (PRP), have been registered since January 1995. Nasopharyngeal specimens were obtained from family members and close contacts of identified carriers. Children were denied attendance at regular day-care until PRP-negative. In 1995 and 1996, PRP were isolated from 882 individuals, 364 of whom had clinical infection and the remaining of whom were asymptomatic carriers. In 49%, the PRP were of serogroup 9, with MIC of penicillin 0.5-2.0 mg/L and resistance to trimethoprim/sulfamethoxazole. Further analyses with serotyping and genetic fingerprinting suggested strongly that most of the isolates belonged to a single serotype 9V clone. Month by month, an apparently continuous spread appeared from one municipality to a neighboring one. In most communities, the serotype 9V PRP appeared and disappeared within a few months. The active procedures of the intervention project may have limited the spread of the clone in the county.
作为一项干预项目的一部分，自1995年1月起，马尔默胡斯郡所有青霉素耐药肺炎球菌培养呈阳性（最低抑菌浓度≥0.5mg/L，即PRP）的患者均已登记在册。从已确认携带者的家庭成员和密切接触者处采集鼻咽标本。在患者PRP检测呈阴性之前，儿童不得进入正规日托机构。1995年和1996年，从882人身上分离出PRP，其中364人有临床感染，其余为无症状携带者。49%的PRP属于9血清群，青霉素最低抑菌浓度为0.5 - 2.0mg/L，对甲氧苄啶/磺胺甲恶唑耐药。血清分型和基因指纹分析进一步表明，大多数分离株属于单一的9V血清型克隆。逐月来看，一个市镇到相邻市镇出现了明显的持续传播。在大多数社区，9V血清型PRP在几个月内出现又消失。干预项目的积极措施可能限制了该克隆在该郡的传播。
