Abstract:

Objective    To investigate the clinical distribution， serotypes and patterns of antibiotic resistance of Streptococcus pneumonia isolated in pediatric in-patients. Methods    The clinical specimen from children hospitalized in Beijing
Children’s Hospital，Capital Medical University from March 2013 to February 2014 were cultured. Serotyping of streptococcus pneumoniae was carried out by capsule swelling test. Identification and antimicrobial susceptibility was determined by Phoenix 100 microbiological system. Results were analyzed according to the guidelines of Clinical and Laboratory Standard Institute （2013）. WHONET 5.6 software was used to analyse the data. Results    66.1% were isolated from children under 3 years old from 195 strains of streptococcus pneumoniae. Twenty serotypes of 195 strains of streptococcus pneumoniae were identified. The main serotypes were 19F and 19A，32.3% and 20.5% respectively. The non-susceptibility rate of streptococcus pneumoniae to erythromycin and clindamycin was very high. The non-susceptibility rate of streptococcus pneumoniae to penicillin was 46.7%. The non-susceptibility rates to cefotaxime， cefepime， meropenem and trimethoprim-sulfamethoxazol in penicillin-non susceptible streptococcus pneumoniae（PNSP） were markedly higher than penicillin-susceptible streptococcus pneumoniae（PSSP），and the difference had no statistical significance（P＜0.05）. Conclusion    In Department of Pediatrics，the detection of streptococcus pneumoniae，the determination of serotypes and drug risistance can not be ignored. Vaccination and proper antibiotics should be given in anti-infection treatment.

Key words: streptococcus pneumoniae, child, serotype, drug resistance

摘要：

目的    分析住院患儿细菌培养标本中所检出肺炎链球菌的分布、血清型及耐药性特征。方法　收集2013年3月至2014年2月在首都医科大学附属北京儿童医院呼吸、感染及重症监护病房住院的195例患儿送检的细菌培养标本，对其进行肺炎链球菌常规检测、血清分型和药物敏感性试验。按照2013年临床实验室标准化委员会（CLSI）推荐的抗菌药物敏感性试验标准进行结果判断。应用WHONET 5.6软件对药敏结果进行耐药性分析。结果　195例患儿分离到肺炎链球菌，其中婴幼儿占66.1%。195例中共检出20种血清型，其中19F最多，占32.3%，其次19A，占20.5%。肺炎链球菌对红霉素和克林霉素最不敏感（敏感率＜5%），对青霉素不敏感率为46.7%。与对青霉素敏感的肺炎链球菌进行抗菌药物耐药性比较后显示，青霉素不敏感肺炎链球菌对头孢噻肟、头孢吡肟、美罗培南和复方新诺明不敏感率均高于敏感菌株，差异存在统计学意义（P＜0.05）。结论　在儿科，肺炎链球菌的检出、流行型别的确定以及耐药性检测均不容忽视，应进行疫苗预防接种和合理选择抗菌药物进行抗感染治疗。

关键词: 肺炎链球菌, 儿童, 血清型, 耐药性