儿童肺炎链球菌感染的血清学分型与耐药状况分析

Analysis of clinical characteristics,serological typing and drug resistance of Streptococcus pneumoniae infection in children

目的了解儿童肺炎链球菌感染的血清型与耐药状况,为临床经验诊治提供参考。方法回顾性分析2013-2018年从临床标本中检出肺炎链球菌感染患儿的临床资料。结果肺炎链球菌的检出率为8. 4%。阳性患儿男性高于女性,年龄以<2岁者为主,占51. 6%。冬季阳性例数最多,占36. 5%。痰液为肺炎链球菌的主要标本来源,阳性标本主要来自儿科,基础疾病主要为肺炎。血清型以19F、19A和23F为主,分别占40. 5%、15. 1%和13. 5%。肺炎链球菌对阿奇霉素、克林霉素、红霉素和四环素的耐药率均处于较高水平,分别为96. 8%、92. 8%、93. 6%和77. 0%,青霉素耐药株对常用抗菌药物的耐药率普遍高于青霉素敏感株。结论肺炎链球菌易引起<2岁婴幼儿呼吸道感染,冬季发病率最高,分离株以19F、19A、23F血清型为主,对大环内酯类抗菌药物耐药率极高。

Objective To understand the clinical characteristics,serotypes and drug resistance of Streptococcus pneumoniae(S. pneumoniae) infection in children,and to provide reference for clinical experience in diagnosis and treatment.Methods The clinical data of children with S. pneumoniae infection from 2013 to 2018 were analyzed retrospectively.Results The detection rate of S. pneumoniae was 8. 4%. Males were higher than females in positive children,with the age of 2 years old,accounted for 51. 6%. The number of positive cases in winter was the highest,accounted for 36. 5%. Sputum was the main source of S. pneumoniae. Positive specimens were mainly from pediatrics and the underlying disease was mainly pneumonia. The serotypes were mainly 19 F,19 A and 23 F,accounting for 40. 5%,15. 1% and 13. 5% respectively.The resistance rates of S. pneumoniae to azithromycin,clindamycin,erythromycin and tetracycline were at a high level of96. 8%,92. 8%,93. 6% and 77. 0% respectively. The resistance rates of penicillin-resistant strains to commonly used antibiotics were generally higher than that of penicillin-sensitive strains. Conclusion S. pneumoniae easily causes respiratory tract infection in infants of <2 years old. The incidence rate in winter is the highest. The isolated strains are mainly serotypes of 19 F,19 A and 23 F. The resistance rate to macrolide antibiotics is extremely high.