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目的了解当前从我国住院肺炎儿童分离的肺炎链球菌血清型分布和不同血清型菌株对抗菌药物的耐药状况,评估应用疫苗预防儿童肺炎链球菌感染和控制耐药菌传播的价值。方法肺炎链球菌分离自4家儿童医院呼吸科年龄≤5岁的住院肺炎患儿,采用荚膜肿胀试验进行血清型分析,E试验法检测菌株对8种抗菌药物的敏感性。结果279株肺炎链球菌中以19F型为最常见(占60.6%),其次为19A(9.7%)、23F(9.3%)和6B(5.4%),7价结合疫苗(PCV7)覆盖率为81.0%,PCV7在青霉素不敏感菌株和敏感菌株中的覆盖率分别为84.2%(202/240)和61.5%(24/39)。超过90%的19F和19A型菌株对青霉素不敏感,19F型以中介株为主(71.6%),19A型以耐药株为主(55.6%)。结论住院儿童肺炎病例分离的肺炎链球菌以19F、19A、23F和6B型常见;PCV7覆盖大多数肺炎链球菌和青霉素不敏感菌株,应用该疫苗可有效地预防国内儿童肺炎链球菌感染和阻止耐药菌株传播;非PCV7覆盖的19A型具有较强耐药性。
Objective To investigate the serotype distribution of Streptococcus pneumoniae isolated from children with pneumonia in hospital and the antibiotic resistance status of different serotype strains in children hospitalized with pneumonia in our country and to evaluate the value of vaccine application to prevent Streptococcus pneumoniae infection in children and to control the spread of drug-resistant bacteria. Methods Streptococcus pneumoniae was isolated from four children hospitalized with pneumonia in our hospital who were less than 5 years old. The capsular swelling test was used to analyze the serotypes. The susceptibility of the strains to eight antibiotics was tested by E test. Results Of the 279 S. pneumoniae strains, type 19F was the most common (60.6%), followed by 19A (9.7%), 23F (9.3%) and 6B (5.4%), and the coverage of PCV7 was 81.0 %. The coverage of PCV7 in penicillin-insensitive and susceptible strains was 84.2% (202/240) and 61.5% (24/39), respectively. More than 90% of 19F and 19A strains were insensitive to penicillin, 19F was predominant (71.6%) and 19A was resistant (55.6%). Conclusion Streptococcus pneumoniae isolated from hospitalized children with pneumonia are common in 19F, 19A, 23F and 6B. PCV7 covers most of the pneumococcal and penicillin-insensitive strains. The vaccine can effectively prevent S. pneumoniae infection and prevent resistance in children in China Drug strains spread; non-PCV7 covered 19A type has strong resistance.