呼吸道感染患儿肺炎链球菌血清分型及耐药性

Serotyping and resistance of Streptococcus pneumonia isolates from children with respiratory tract infection

目的 :研究小儿呼吸道感染患者肺炎链球菌血清分型及其对常用抗生素的耐药性。方法 :肺炎链球菌的鉴定采用涂片革兰染色、胆汁溶菌试验及Optochin纸片鉴定 ,血清分型采用荚膜肿胀试验 ,药敏试验采用青霉素Etest试验及部分抗生素琼脂扩散试验 ,β内酰胺酶的检测采用头孢硝噻酚法。 结果 :96株肺炎链球菌血清型有 19F、2 3F、6A、14、6B、19、18C、35F、11A、35A、2 3A。未发现产 β内酰胺酶菌株。青霉素Etest结果提示青霉素敏感占 5 9.4 % ,低度耐药株占 36 .4 % ,高度耐药株占 4 .2 % ,肺炎链球菌对红霉素、克林霉素均有较高的耐药率。结论 :我院患儿肺炎链球菌血清型分布广泛 ,但相对集中 ,以19F、2 3F为主 ,对青霉素的耐药性以低度耐药为主。

Objective: To investigate the serotyping and resistance of Streptococcus pneumonia . Methods: The identification of Streptococcus pneumonia was performed by Gram stain, bile bacteriolytic test, and by demonstrating its susceptibility to optochin. Serotyping of pneumococci was carried out by capsule swelling test. Antibiotic susceptibility test was performed by disk diffusion method and E test. β lactamase was detected by nitrocefin disco. Results: Serotypes of 76 strains of Streptococcus pneumonia were identibied including 19F, 23F, 6A, 14, 6B, 19, 18C, 35F, 11A, 35A, and 23A. No β lactamase producing strain was found. Antibiotic susceptibility test showed that 59.4% of Streptococcus pneumonia were sensitive to penicillin (PSSP), 36.4% were intermediate(PISP), and only 4.2% were resistant (PRSP). The resistance rates of Streptococcus pneumonia to erythromycin, clindamycin were very high. Conclusions: The serotypes of Streptococcus pneumonia were widely distributed and more concentrated on serotype 19F and 23F. Most penicillin nonsusceptible Streptococcus pneumonia strains were PISP strains produced in low degree.