234株儿童感染A组溶血性链球菌耐药特征分析

Drug resistance of 234 strains of group A Streptococcus isolated from children

目的分析北京市顺义区儿童呼吸道感染A组溶血性链球菌(group A streptococci,GAS)的耐药特征。方法收集顺义区妇幼保健院2013—2019年间就诊的猩红热或细菌性咽扁桃体炎患儿咽拭子,分离鉴定出234株GAS,采用微量肉汤稀释法检测GAS对青霉素、红霉素、克林霉素、氯霉素、左氧氟沙星、氧氟沙星、四环素、万古霉素、头孢吡肟、头孢噻肟、美罗培南、利奈唑胺12种抗生素的最低抑菌浓度(MIC)。结果234株GAS对青霉素、头孢吡肟、头孢噻肟、万古霉素、美罗培南、利奈唑胺均敏感;对红霉素、克林霉素、四环素耐药率分别为98.29%、97.01%、93.16%;对氧氟沙星、左氧沙星、氯霉素耐药率分别为2.56%、0.43%、0.43%;本研究结果显示共分布8种耐药谱,优势耐药谱为红霉素–克林霉素–四环素联合耐药,占89.74%(210/234),多重耐药率为92.74%(217/234)。结论北京市顺义区儿童呼吸道感染的GAS对大环内酯类、克林霉素、四环素耐药率高,多重耐药严重,对青霉素和头孢类抗生素仍敏感。GAS的监测及耐药性分析仍需持续加强。

Objective To analyze the drug resistance characteristics of group A Streptococcus isolated from children with respiratory infection in Shunyi district of Beijing.Methods The throat swabs of children with scarlet fever or acute pharyngal tonsillitis were collected in Shunyi Maternal and Child Healthcare Center during 2013–2019,and a total of 234 strains of group A Streptococcus were isolated and identified.The minimum inhibitory concentrations of 12 antibiotics to group A Streptococcus were tested.Results All the 234 strains of group A Streptococcus were sensitive to penicillin,cefepime,cefotaxime,vancomycin,meropenem and linezolid;the resistance rates to erythromycin,clindamycin and tetracycline were 98.29%,97.01%,and 93.16%respectively;the resistance rates to ofloxacin,levofloxacin and chloramphenicol were 2.56%,0.43%and 0.43%respectively;there were 8 kinds of resistance spectrums,the dominant resistance spectrum was erythromycin-clindamycin-tetracycline combined resistance,accounting for 89.74%(210/234),and the multi-drug resistance rate was 92.74%(217/234).Conclusion The drug resistance rates of group A Streptococcus isolated from the respiratory tracts of sick children to macrolides,clindamycin and tetracycline remained at high levels in Shunyi,and the multi-drug resistances were serious,while group A Streptococcus was sensitive to penicillin and cephalosporins.It is still necessary to further strengthen the surveillance for group A Streptococcus and the evaluation of its drug resistance.