四川省自贡市儿童与成人分离肺炎链球菌株的血清型分布及抗生素敏感性比较

Streptococcus pneumonia distributed in different serotypes isolated from children and adults,and their antibiotic sensitivity:A study in Zigong,Sichuan

目的通过对四川省自贡市儿童与成人分离肺炎链球菌株常见血清型及抗菌素敏感性分析比较,了解不同人群分离肺炎菌的血清型特点及药物敏感特点,用于指导本地区疫苗及抗菌素的合理运用。方法以2009年6月至2010年6月从自贡四家医院门诊、住院部分离的166株肺炎链球菌为研究对象,采用琼脂稀释法检测最低抑菌浓度(MIC)及抗生素的药物敏感性;通过荚膜肿胀实验检测其血清型,对菌株敏感性分析采用WHONET5.3软件进行分析。结果儿童常见血清型为19、23、14、6和15群,成人分离的菌株常见血清型为19、23、18、5和33群,两人群分离菌株除19和23群外,其余血清型存在较大的差异(P<0.05);成人分离菌株对青霉素的敏感率显著高于儿童,差异有统计学意义(χ2=7.60,P<0.05);两人群分离出的菌株对阿奇霉素、克林霉素敏感率均较低,对头孢唑林和左氧氟沙星敏感率均较高,差异均无统计学意义(P>0.05)。结论四川省自贡市儿童和成人分离的肺炎链球菌常见血清学型群存在差异,对于疫苗选择存在差异;两人群分离菌对左氧氟沙星、头孢唑林、青霉素敏感率相对较高,对阿奇霉素及克林霉素的敏感率均低。

Objective The aim of this study was to investigate the common serotypes and antibiotic sensitivity of streptococcus pneumonia from children and adults in Zigong, Sichuan, and provide clinical guidelines for the rational use of vaccine and antimicrobial agents for streptococcus pneumonia. Methods Drug sensitivity of 166 streptococcus pneumoniae strains from four hospitals were tested between Jun 2009 and Aug 2010 in Zigong. Minimum inhibitory concentration （M1C） and the drug sensitivity of antibiotics were determined by agar dilution method. The serotype was performed by the quellung reaction. The raw data of the drug sensitivity test was analyzed by WHONET 5.3. Results The most common serotypes in children were 19,23,14,6,15,and those in adults were 19,23,18, 5,33. Besides serotype 19 and serotype 23, other serotypes reported significant difference between the two groups of people （P 〈 0. 05 ）. The Benzylpenicillin sensitivity rates of strains isolated from adults and those from children was statistically significant （ x^2 = 7.60, P 〈 0.05 ）. Strains isolated from both two groups （NS,P 〉 0.05 ） have a low sensitivity rate to Azithromycin and Clindamycin, and a high sensitivity rate to Cefazolin and Levofloxacin. Conclusion The most common serotypes of streptococcus pneumonia isolated from children were different from those isolated from adults. The two groups can choose different vaccines. The isolates had a comparatively high sensitivity to Levofloxacin, Cefazolin and Benzylpenicillin, while a low sensitivity to Azithromycin and Clindamycin.