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目的了解苏州地区在7价肺炎链球菌结合疫苗(7 heptavalent pneumococcal conjugate vaccine,PCV7)引入前,不同临床治疗压力下肺炎链球菌分离株的耐药特征、血清分型及国际流行耐药克隆株(pneumococcal molecular epidemiology network,PMEN)的流行情况。方法收集2006年3月~2007年3月期间苏州大学附属儿童医院住院治疗的呼吸道感染儿童(病例组)和非呼吸道感染儿童(对照组)中分离的肺炎链球菌134株,进行抗生素敏感性分析和血清型分型,并对其中86株大环内酯类药物菌株进行基因分型。结果病例组抗生素的使用率高于对照组(2=111.19,P<0.001)。病例组分离的菌株血清型以19F、19A和14为主,对照组菌株常见的血清型为6B、19F和23F,两组PCV7血清型覆盖率分别为58.3%和68.1%。对照组菌株对常用抗生素的敏感性均高于病例组(均有P<0.05)。菌株基因分型共检测出10种PMEN克隆株,最常见的为Taiwan19F-14克隆株。PMEN克隆株对常用抗菌药物的不敏感率高于非PMEN克隆株。结论在我国引入PCV7前,在抗生素等治疗压力下,苏州地区肺炎链球菌的耐药情况严重,以Taiwan19F-14克隆株流行为主,多种PMEN克隆株并存。
Objective To investigate the drug resistance of serotypes of Streptococcus pneumoniae in different clinical treatment pressure before the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in Suzhou in China. pneumococcal molecular epidemiology network, PMEN). Methods A total of 134 S. pneumoniae isolates from children with respiratory tract infection (case group) and non-respiratory infection children (control group) hospitalized from March 2006 to March 2007 in Children’s Hospital of Soochow University were collected for antibiotic susceptibility analysis And serotypes, and genotype 86 strains of macrolide drugs. Results The use rate of antibiotics in case group was higher than that in control group (2 = 111.19, P <0.001). The serotypes of the isolates from the case group were 19F, 19A and 14, and the common serotypes of the control strains were 6B, 19F and 23F. The seroprevalence of PCV7 in the two groups was 58.3% and 68.1%, respectively. The sensitivity of the control strains to commonly used antibiotics was higher than that of the case group (all P <0.05). Ten strains of PMEN were detected by genotyping, the most common being Taiwan19F-14 clone. PMEN clones were less susceptible to commonly used antibacterials than non-PMEN clones. Conclusions Before the introduction of PCV7 in our country, under the treatment of antibiotics and other treatments, the prevalence of S. pneumoniae in Suzhou was serious. The epidemic of Taiwan19F-14 clone was the main one, and many kinds of PMEN clones co-existed.