论文部分内容阅读
目的探讨佛山地区小儿肺炎链球菌(SP)的临床分布特征及耐药性。方法收集佛山市顺德区妇幼保健院住院部2015年1月—2016年10月收治的患儿标本分离出的SP 356株,进行临床分布、耐药情况及耐药基因进行分析。结果 356株SP来源痰液占47.75%,居第一位;血液占17.70%,居第二位;气管内分泌物占13.20%,居第三位;眼分泌物占8.15%,居第四位。SP临床标本分布比较,差异有统计学意义(P<0.05)。356株SP冬季检出率最高,夏季检出率最低。SP季节分布比较,差异有统计学意义(P<0.05)。SP对红霉素耐药率最高,为95.6%,对四环素和克林霉素耐药率分别为84.5%、87.4%,其次是对复方磺胺甲噁唑耐药率为66.01%,SP菌株对万古霉素和利奈唑胺敏感。356株SP中耐药基因包括erm B、mef E、mef A、pbp2b基因突变、pbpla基因突变及Tn1545转座酶基因。SP各耐药基因阳性率比较,差异有统计学意义(P<0.05)。耐药基因以携带erm B基因和Tn1545转座酶基因为主。结论本地区分离的SP耐药较为严重,且更多的表现为多重耐药;耐药机制主要表现erm B编码、mef E编码、pbp2b基因突变和Tn1545接合性转座子介导的耐药传播为主。
Objective To investigate the clinical distribution and drug resistance of pediatric Streptococcus pneumoniae (SP) in Foshan area. Methods The SP 356 isolates from children hospitalized in Shunde District of Foshan City from January 2015 to October 2016 were collected and analyzed for clinical distribution, drug resistance and resistance genes. Results The SP sputum from 356 patients accounted for 47.75%, ranking first; blood accounted for 17.70%, ranking second; tracheal secretions accounted for 13.20%, ranking third; eye secretions accounted for 8.15%, ranking fourth. SP clinical specimen distribution comparison, the difference was statistically significant (P <0.05). The highest detection rate of 356 strains of SP in winter, the lowest detection rate in summer. SP seasonal distribution, the difference was statistically significant (P <0.05). The highest rate of resistance to erythromycin was 95.6% for SP and 84.5% for tetracycline and clindamycin, 87.4% for clindamycin, followed by 66.01% for sulfamethoxazole. SP strain Vancomycin and linezolid sensitive. The resistance gene of 356 isolates including erm B, mef E, mef A and pbp2b gene mutations, pbpla gene mutation and Tn1545 transposase gene. There was significant difference in the positive rate of each drug resistance gene (P <0.05). Resistance gene to carry erm B gene and Tn1545 transposase gene based. Conclusion The resistance of SP isolates in this area is more serious, and more often shows multi-drug resistance. The mechanisms of drug resistance mainly include erm B coding, mef E coding, pbp2b gene mutation and Tn1545 adapter transposon-mediated drug resistance transmission Mainly.