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目的明确1997—2007年分离自北京儿童医院门诊上呼吸道感染患儿鼻咽部的6群肺炎链球菌的型别构成和对抗菌药物敏感性状况,及其年代变化特点。方法采用荚膜肿胀试验鉴定6群、6A和6B型;采用multi-bead assay分型方法从6A型中鉴定6C型;用E试验法检测青霉素等8种抗菌药物对细菌的MIC。结果 1997—2007年分离到肺炎链球菌893株,从中鉴定出6群119株(13.3%),包括6A型71株(59.7%)、6B型39株(32.7%)和6C型9株(7.6%)。6群菌株对青霉素、头孢呋辛和红霉素的不敏感率分别从1997—2000年的3.4%、1.7%和86.2%上升到2005—2007年的29.4%、23.5%和100%,MIC90和最大MIC值也升高。6A、6B和6C型菌对青霉素的不敏感率分别为7.2%、24.3%和0。结论北京儿童医院呼吸道感染患儿分离的病原菌6群肺炎链球菌以6A型(59.7%)为主,存在新发现的6C型;6群肺炎链球菌对β内酰胺类抗生素和红霉素的耐药性在增加,6B型菌株抗生素耐药性较6A型、6C型强。
Objective To clarify the type constitution and antimicrobial susceptibility of 6 groups of Streptococcus pneumoniae isolated from the nasopharynx of children with upper respiratory tract infection in Children’s Hospital of Beijing Children’s Hospital from 1997 to 2007 and their chronological changes. Methods Six capsule types 6A, 6B were identified by capsular swelling test. Type 6C was identified from type 6A by multi-bead assay. The MICs of eight antibiotics, such as penicillin, against bacteria were tested by E-test. Results A total of 893 strains of Streptococcus pneumoniae were isolated from 1997 to 2007, of which 119 strains (13.3%) were identified as 6 groups, including 71 strains of 6A (59.7%), 39 strains of 6B (32.7%) and 9 strains of 6C %). Insensitivity to penicillin, cefuroxime and erythromycin in the 6 group strains increased from 3.4%, 1.7% and 86.2% in 1997-2000 to 29.4%, 23.5% and 100% respectively in 2005-2007. MIC90 and MIC50 The maximum MIC value also rises. The insensitivity rates of penicillins to type 6A, 6B and 6C were 7.2%, 24.3% and 0, respectively. Conclusions 6 strains of Streptococcus pneumoniae isolated from children with respiratory tract infection in Beijing Children’s Hospital were predominantly type 6A (59.7%), with newly discovered type 6C. Six Streptococcus pneumoniae strains were resistant to beta-lactam antibiotics and erythromycin The drug resistance is increasing. The antibiotic resistance of 6B strain is stronger than that of 6A and 6C.