肺炎链球菌的耐药性及其血清型分布调查

Resistance and Serotype of Streptococcus Pneumoniae in Zhongshan City

目的 了解中山市肺炎链球菌的耐药性及其血清型分布情况 ,比较正常人群肺炎链球携带株与临床分离株的耐药性与血清型分布关系 ,探讨肺炎链球菌的耐药性和血清型分布特点。 方法 肺炎链球菌的培养、分离和鉴定按《全国临床检验操作规程》进行 ;药敏试验根据美国临床实验室标准委员会 (NCCLS)有关抗生素敏感性试验法规进行试验并对结果进行判定 ;肺炎链球菌分型使用Quellung反应方法。 结果 2 66株肺炎链球菌中耐青霉素肺炎链球菌占2 6.7% ;耐青霉素肺炎链球菌对红霉素、四环素、氯霉素、克林霉素、利福平和复方新诺明的耐药率高达 97.1%、10 0 %、5 6.3 %、84.5 %、42 .5 %、78.9% ;在所有菌株中排在前 9位 (占所有血清型的 65 .9% )的常见血清型是 2 3F (13 .2 % )、6A(12 .4% )、19F(10 .9% )、6B(7.1% )、14 (6.4% )、15B(5 .3 % )、NT(5 .3 % )、19A(3 .0 % )、2 2F(2 .3 % )。而 71株对青霉素不敏感的菌株中排在前 9位的常见血清型分别为 19F、2 3F、14型、不能分型、6B、2 2F、9V、19B和 3 3F。目前推荐使用的 2 3价肺炎球菌多糖疫苗 (1,2 ,3 ,4,5 ,6B ,7F ,8,9N ,9V ,10A ,11A ,12F ,14 ,15B ,17F ,18C ,19A ,19F ,2 0 ,2 2F ,2 3F ,3 3F)能覆盖所有分离菌株血清型 71.9%。 结论 在携带?

Objective This study is designed to investigate bacterial resistance and the prevalence of serotype of Streptococcus pneumoniae. Methods Sensitivity to penicillin, cefotaxime, erythromycin, tetracycline, chloramphenicol, clindamycin, ofloxacin, Rifampin, vancomycin and trimethoprim-sulfamiethoxazole was determined by K-B and E-test methods according to NCCLS. Serotyping of the Streptococcus Pneumoniae strains was performed by using Quelling Reaction. Result Resistance of 266 species Streptococcus Pneumoniae were as follows: Penicillin, 26.7 %(22.9% intermediate; 3.8% resistant); erythromycin, 65.4%; tetracycline, 51.7%; chloramphenicol, 45.8%; clindamycin, 53.0%; cefotaxime, 5.0%; Rifampin, 36.5%; ofloxacin, 1.5%; vancomycin, 0% and trimethoprim-sulfamiethoxazole, 66.5%. Serotype 23 F ( 13.2% ),6 A (12.4%),19 F (10.9%),6 B (7.1%),14 (6.4%),15 B (5.3%),NT(5.3%),19 A (3.0%),22 F (2.3%) were most common. Conclusion These data show that carriage of antibiotic-resistant pneumococcal is high in Zhongshan city. Erythromycin, Tetracycline, Chloramphenicol, Clindamycin and Trimethoprim-sulfamiethoxazole resistance was very common. All strains were susceptible to Vancomycin. This study showed that Pneumococcal Vaccine Polyvalent did cover the majority of strains isolated.