中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
22期
1565-1570
,共6页
刘春林%赵春江%刘昱东%王辉
劉春林%趙春江%劉昱東%王輝
류춘림%조춘강%류욱동%왕휘
链球菌,肺炎%血清分型%抗药性,微生物%多位点序列分型%侵袭性疾病
鏈毬菌,肺炎%血清分型%抗藥性,微生物%多位點序列分型%侵襲性疾病
련구균,폐염%혈청분형%항약성,미생물%다위점서렬분형%침습성질병
Streptococcus pneumoniae%Serotyping%Drug resistance,microbial%Multilocus sequence typing%Invasive diseases
目的 研究临床分离的侵袭性肺炎链球菌血清型分布、耐药性及分子流行病学特点,为抗生素的应用和免疫预防提供参考依据.方法 收集2005年1月至2008年8月全国15个地区148株来自血液、脑脊液等侵袭性感染部位的肺炎链球菌.采用琼脂稀释法测定青霉素等抗生素对148株肺炎链球菌的最低抑菌浓度(MIC);采用简易棋盘式肺炎链球菌分型系统和荚膜肿胀实验进行血清分型;多位点序列分型(MIST)技术对53株19群菌株进行基因分型,了解其与国际流行株的关系.结果 血清分型共检出20个血清型/群,主要集中在19A、19F、3、23F、5、6、14和9血清型/群,共计105株,占70.9%,以19A(22.3%,33/148)、19F(16.9%,25/148)最常见,其次为3群(7.4%,11/148)和23F(6.8%,10/148).7价疫苗(PCV7)在2岁以下儿童中的覆盖率为33.3%(12/36).PCV7相关血清型肺炎链球菌对阿莫西林/克拉维酸、红霉素等耐药率均明显高于非疫苗相关血清型菌株(P<0.05).53株19群肺炎链球菌MIST分析共检出9种序列型(ST),其中以ST320(28/53,52.8%)和ST271(12/53,22.6%)为主.结论 我国侵袭性肺炎链球菌血清分型以19A、19F、3和23F血清型为主.侵袭性肺炎链球菌耐药情况严重.
目的 研究臨床分離的侵襲性肺炎鏈毬菌血清型分佈、耐藥性及分子流行病學特點,為抗生素的應用和免疫預防提供參攷依據.方法 收集2005年1月至2008年8月全國15箇地區148株來自血液、腦脊液等侵襲性感染部位的肺炎鏈毬菌.採用瓊脂稀釋法測定青黴素等抗生素對148株肺炎鏈毬菌的最低抑菌濃度(MIC);採用簡易棋盤式肺炎鏈毬菌分型繫統和莢膜腫脹實驗進行血清分型;多位點序列分型(MIST)技術對53株19群菌株進行基因分型,瞭解其與國際流行株的關繫.結果 血清分型共檢齣20箇血清型/群,主要集中在19A、19F、3、23F、5、6、14和9血清型/群,共計105株,佔70.9%,以19A(22.3%,33/148)、19F(16.9%,25/148)最常見,其次為3群(7.4%,11/148)和23F(6.8%,10/148).7價疫苗(PCV7)在2歲以下兒童中的覆蓋率為33.3%(12/36).PCV7相關血清型肺炎鏈毬菌對阿莫西林/剋拉維痠、紅黴素等耐藥率均明顯高于非疫苗相關血清型菌株(P<0.05).53株19群肺炎鏈毬菌MIST分析共檢齣9種序列型(ST),其中以ST320(28/53,52.8%)和ST271(12/53,22.6%)為主.結論 我國侵襲性肺炎鏈毬菌血清分型以19A、19F、3和23F血清型為主.侵襲性肺炎鏈毬菌耐藥情況嚴重.
목적 연구림상분리적침습성폐염련구균혈청형분포、내약성급분자류행병학특점,위항생소적응용화면역예방제공삼고의거.방법 수집2005년1월지2008년8월전국15개지구148주래자혈액、뇌척액등침습성감염부위적폐염련구균.채용경지희석법측정청매소등항생소대148주폐염련구균적최저억균농도(MIC);채용간역기반식폐염련구균분형계통화협막종창실험진행혈청분형;다위점서렬분형(MIST)기술대53주19군균주진행기인분형,료해기여국제류행주적관계.결과 혈청분형공검출20개혈청형/군,주요집중재19A、19F、3、23F、5、6、14화9혈청형/군,공계105주,점70.9%,이19A(22.3%,33/148)、19F(16.9%,25/148)최상견,기차위3군(7.4%,11/148)화23F(6.8%,10/148).7개역묘(PCV7)재2세이하인동중적복개솔위33.3%(12/36).PCV7상관혈청형폐염련구균대아막서림/극랍유산、홍매소등내약솔균명현고우비역묘상관혈청형균주(P<0.05).53주19군폐염련구균MIST분석공검출9충서렬형(ST),기중이ST320(28/53,52.8%)화ST271(12/53,22.6%)위주.결론 아국침습성폐염련구균혈청분형이19A、19F、3화23F혈청형위주.침습성폐염련구균내약정황엄중.
Objective To investigate the serotype distribution, antimicrobial resistance patterns and molecular epidemiology of Streptococcus pneumoniae ( 5. pneumoniae) isolated from invasive pneumococcal diseases in order to provide rationales for antibiotics application and immunity control of 5. pneumoniae. Methods A total of 148 isolates of invasive S. pneumoniae were collected from blood, cerebrospinal fluid and other sterile body fluids from 15 regions between January 2005 and August 2008 nationwide. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of penicillin and other antibiotics against these isolates. Simplified chessboard system and capsule swelling reaction were used for serotyping of S. pneumoniae. Multilocus sequence typing ( MLST) was used to determine the genetic relationship of 53 strains of serogroup-19. Results Twenty serotypes/serogroups were identified in 148 strains. The prevalent serotypes (70. 9% ) were 19A, 19F, 3, 23F, 5, 6, 14 and 9 respectively. Serotypes 19A (22. 3% , 33/148) and 19F (16. 9% , 25/148) were the most frequent type observed. And serotypes 3 (7. 4% , 11/148) and 23F(6. 8% , 10/148) were less prevalent Of all 36 strains isolated from infants under 2 years old, 33. 3% (12/36) were covered by 7-valent pneumococcal conjugate vaccine (PCV7). The resistant rates to amoxicillin/clavulanic acid, erythromycin and other antibiotics in PCV7-related pneumococcal strains were significantly higher than those in PCV7-unrelated group (P < 0. 05). Fifty-three strains of serogroup-19 were genotyped by MLST and 9 sequence types (STs) identified. ST320 (52. 8% , 28/53) and ST271 (22.6% , 12/53) were the most frequent STs. Conclusions The major serotypes of invasive S. pneumoniae are 19A, 19F, 3 and 23F. Antimicrobial-resistant S. pneumoniae has become a serious issue of public health.
